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Sex and Values at Rodale
We believe that an active and healthy sex life, based on mutual consent and respect between partners, is an important component of physical and mental
well-being. We also respect that sex is a private matter and that each person has a different opinion of what sexual practices or levels of discourse are
appropriate. Rodale is committed to offering responsible, practical advice about sexual matters, supported by accredited professionals and legitimate
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© 2011 by Rodale Inc.
INTRODUCTION
Your Sex Life Is About to Get a Whole Lot Better!
CHAPTER ONE
“AM I NORMAL?”
Just how long should a man last in bed? The surprising answers…
CHAPTER TWO
THE HIDDEN SECRETS OF AROUSAL
Use them to your advantage (and hers)
CHAPTER THREE
HE CAME. HE CONQUERED.
How one man beat PE
CHAPTER FOUR
THE PE PLAYBOOK
Your arsenal of advice for negotiating a cease-fire
CHAPTER FIVE
THE DO-IT-YOURSELF CURE
Relearn a handy technique for going the distance
CHAPTER SIX
HELP HER HELP YOU
The more you do this, the more you’ll do it
CHAPTER SEVEN
A LOW, SLOW BURN
The foreplay formula that will extend your pleasure and hers
CHAPTER EIGHT
BIGGER, BOLDER, BETTER
Exercises, pills, even surgery—they all promise to make your penis bigger. But do they work? Here’s the truth.
CHAPTER NINE
THE BETTER-SEX WORKOUT
A shape-up-fast plan for sexual stamina, greater pleasure—and awesome abs!
CHAPTER TEN
DOWNWARD DOGGIE STYLE
Research shows that yoga helps PE. Here are 6 last-longer moves any man can master.
BONUS CHAPTER
13 SECRETS TO ROCK-HARD ERECTIONS
The hidden link between erectile dysfunction and premature ejaculation—and how to ensure you’re never blindsided by
either
INTRODUCTION
Your Sex Life Is About to Get a Whole Lot Better!
Ultimately, it was the “start-stop” method that pushed my fiancée, Tara, over the edge. What with so much stopping and so
little starting, not to mention all my various instructions—“Slow down, easy, easy, okay, go ahead, stop, I said stop!”—she
finally blurted out, “Jesus, are we having sex or parking a car?”
As she jumped out of bed and reached for her clothes, I pleaded, “Wait…you can’t just get up and go—”
“Why not? That’s what you do every time we have sex.”
I stammered and said something about lasting 10 seconds—2 more than last month. She said something about
menopause and how maybe we’d be able to have sex for a whole minute by then.
“I’m so sick and tired of saying, ‘It’s okay, really,’ every time we have sex,” she yelled. “It’s not okay! This is your
problem, not mine. And if you don’t get it figured out by the time I get back from Hong Kong, the engagement is off!”
***
Ejaculating too soon is one of a man’s greatest secret fears.
You probably understand that all too well. After all, you downloaded this book for a reason: to find relief from
premature ejaculation (PE) and improve your sex life. You believe that PE strikes a blow at the very core of your
masculinity—your ability to satisfy a woman’s sexual needs.
It’s embarrassing. It hurts your self-esteem. If you’re a pleaser—that is, if you have the kind of personality that
puts a high value on pleasing others—it may even cause you to avoid sexual encounters for fear of underperforming and
disappointing.
The personal account you just read comes from a man named Ian Kerner. Did he cure his PE by the time his fiancée
returned? No spoiler here: You’ll find out the rest of his story in Chapter 3. But here’s a clue: He now has a PhD and is one
of the country’s leading sex experts.
His story highlights how devastating PE can be for men, and how it brings soul-crushing stress to every relationship.
The goal of this book is to convince you that worrying about your performance is counterproductive and often unwarranted
and that there are effective techniques that can help you. Living with sexual anxiety of any kind is no way to live. The help
you are looking for is right here. Read on—your sex life is about to get a whole lot better.
You Are Not Alone
Your desire to delay ejaculation is probably common to the majority of men. One survey found that up to 75 percent of men
would like to last longer before ejaculating. That doesn’t mean they all have PE. Just how many do have it is a tough number
to pinpoint. Some estimates put it as high as 40 percent worldwide. The Premature Ejaculation Prevalence and Attitudes
study, an Internet survey of more than 12,000 men in three countries, reported the prevalence of PE to be 24 percent for the
US sexually active male population, while it was 20 percent in both England and Italy.
That’s a lot of men. As a study in the Archives of Sexual Behavior notes, PE is the single most common male
sexual dysfunction. It’s more common than even impotence, and more worrisome because, well, a little blue pill can fix
many cases of impotence, but there’s currently no Viagra-like drug available in the United States that will help a man last
longer in bed.
(A few years ago in Europe, Johnson and Johnson began selling the first prescription drug designed specifically to
treat PE. Read more about pharmaceutical treatments in Chapter 4.)
A New Pe Epidemic?
Many experts report a sharp rise in men complaining of PE. When urologist Michael Werner, MD, opened his first practice
in Purchase, New York, 15 years ago, about 5 percent of his patients complained about it. Today, that number is about 30
percent.
Why the jump?
In the past 40 to 50 years, men haven’t suddenly evolved into hyperejaculating creatures. As you’ll read in the
following chapters, we’ve always been that way because it gave us a reproductive advantage in the caveman days. Fast sex
equaled safe sex when you were poaching a female who’d been spoken for by an alpha male.
Now, fast-forward to today’s sexuality. Women are more empowered and sexually free, which means we feel more
pressure to please them. And look at the mainstreaming and proliferation of free Internet porn (yes, look…and look…okay,
stop looking), which has altered our standards for bedroom performance.
Suddenly PE is no longer a beneficial trait.
Coming too soon not only can cause psychological disturbances, self-esteem issues, and other sexual dysfunction
such as low libido, but also can affect both partners, creating emotional distance and sexual avoidance. Women often say
that the self-criticism and apologies men offer after ejaculating too soon are real turnoffs.
“My boyfriend Matt’s PE ended our relationship,” says Michele F. “I couldn’t understand it. I enjoyed our sex life,
but he was obsessed with us coming at the same time. Well, I just couldn’t get off through intercourse all the time. I started
thinking that I was the problem.”
It’s no surprise, then, that PE is a major concern of many, many men who will do almost anything to last longer
in the sack. Those we spoke with said they’ve downed shots of whiskey, undergone hypnosis, and even tied elastic bands
around their penises in attempts to stave off the inevitable (ouch!).
***
It’s safe to say that every man has experienced a too-rapid ejaculation at some time in his sexual life. But you should
recognize that some of your anxiety about PE may be overblown. Consider this: Women are far less likely than men to care
or even notice how long the actual intercourse part of sex lasts as long as there is adequate foreplay.
In one study published in the Archives of Sexual Behavior, researchers found that while 24 percent of men claimed
they had a PE problem, only 10 percent of their partners agreed. The rest were unbothered. “There’s some cultural
expectation that the longer you last, the better you are,” says Gale Golden, a licensed social worker, a clinical associate
professor of psychiatry at the University of Vermont, and the author of In the Grip of Desire. “[Men] believe that if they last
longer, they’ll be better able to bring a woman to orgasm.”
But most women can’t reach orgasm through intercourse alone anyway; they need oral and/or manual stimulation.
So, to be a truly amazing lover, a man needs to understand a woman’s need for foreplay and clitoral stimulation. That’s why
the second part of this book is devoted to dozens of techniques for pleasing a woman and becoming her best lover ever. By
learning how to focus on bringing her to orgasm using manual and oral stimulation, a man can ease the pressure to perform
and relax, which will go a long way toward helping him delay ejaculation.
That’s just one set of stats and facts that can help reassure you, but it’s only the beginning. Many questions remain
about PE.
• How can I judge if I have a real problem?
• What causes PE?
• What can I do to delay the inevitable?
• How can I get rid of all the anxiety I have about sexual performance in general?
Those are crucial questions. This book answers them. Guess what? All the news is good: Most doctors and sex
therapists agree that PE is treatable and that there are effective techniques for training yourself to last longer.
If that’s true, then what’s holding up the party? Many men are too embarrassed to seek help or are unconvinced
that the problem can be remedied. The PE Prevalence and Attitudes survey found that only 9 percent of men with PE have
consulted their physicians about it.
Even if you’ve never spoken to a professional about PE, just reading this book is a terrific step in the right direction.
It means you want help and are open-minded enough to try some new (and proven!) techniques. In fact, this book is your
new secret weapon: a step-by-step action plan of strategies that will help you train yourself to delay the point of no return
during sex. Think of it as training for a marathon or weight lifting for size and strength, except in this case instead of
building stronger legs and bigger biceps, you will be building stronger, healthier erections and more stamina and control
over your ejaculation.
And there’s more. This book also challenges other below-the-belt anxieties like erectile dysfunction (impotence) and
penis size. Like PE, worry about size can cause significant psychological trauma. Millions of men judge themselves to be
“undersized,” thinking they need the penis of a porn star to satisfy a woman. It’s not true—not even close—and an entire
section of this book deals with our obsession with size. It’s simple, men: Size does not matter. And this book will show you
why.
Lose the Anxiety, Live (and Love) Better
It’s time to take control of your sex life. The following chapters will tell you everything you need to know about PE and
sexual anxiety and what you need to do to break free of sexual performance issues and start living a full, satisfying sex life
with your partner.
CHAPTER ONE
“AM I NORMAL?”
Just how long should a man last in bed? The surprising answers…
Okay, so what exactly constitutes ejaculating prematurely? What is too quick from a clinical standpoint? One minute? Three
minutes? Five?
The real answer: It depends.
That’s a frustrating answer, but “normal” is meaningless when you’re talking about sex. Sexual excitement and
ejaculation are so sophisticated and nuanced—involving intertwining mental, emotional, and physical triggers that are both
baked-in and acquired—that pinpointing a hard and fast length is not merely difficult, it’s impossible. Also remember that it
takes two to tango, and any partner you choose to do the carnal cha-cha-cha with has her own secret stash of turn-ons, turnoffs, and hot spots that mold her sexual psyche. So assigning a minimum duration to sex is like asking Picasso to paint by
numbers.
Still, that hasn’t stopped doctors and researchers from trying their best to clarify what “premature” means. Some of
their answers make sense, and some don’t. Here are the most common yardsticks they use, and how useful their findings are
in the real world (i.e., the average guy’s bedroom).
Thrusts
Some researchers have defined PE by the number of penile thrusts occurring before ejaculation, with less than 8 to 15 thrusts
being associated with PE.
Useful? Not really. What was the average ground speed of the thrusts? How long was foreplay going on (meaning
how long did the man spend all hot and bothered before actual penetration)? And really, how many couples out there count
thrusts? Don’t answer that!
Time
This is probably the most common method used in trying to define PE. But again, the experts are all over the place. For
example, in his book Sexual Behavior in the Human Male, legendary sex researcher Alfred Kinsey, PhD, wrote that the
average man could maintain penetrative thrusting for about 2 minutes.
In 2008, the International Society for Sexual Medicine, hoping to give doctors some frame of reference, published
the first diagnostic criteria for PE: A man with lifelong PE cannot last longer than 1 minute, and his time to ejaculation is
harming his relationships.
Most current studies rely on intravaginal ejaculatory latency time (IELT), a measurement of the duration between
insertion and ejaculation. Even here, however, there is a notable lack of consensus because IELTs typically range from 1 to
7 minutes. The most widely adopted temporal yardstick is that men who generally last less than 1 minute have definite PE
and men who usually last between 1 and 1 1/2 minutes have probable PE. Using these definitions, about 1 man in 200 has
definite PE and 3 in 100 have probable PE. The primary flaw in this measurement is that a handful of marathon men can
skew the numbers significantly, not to mention the inherent hurdles involved in timing couples accurately as they copulate.
Useful? Of course not. Letting a time limit define PE doesn’t take into account the individual nature of each man’s
sex drive and response. Some men’s responses are so sensitive that they ejaculate before penetration or within seconds of
entry. Other men who say they suffer from PE actually have completely normal levels of sexual stamina, lasting 6 minutes
or longer.
Her Orgasm
Though employed less frequently, some researchers define premature ejaculation as “the inability to control and defer
ejaculation until the female partner was sexually satisfied on at least 50 percent of intercourse attempts.”
Useful? Seriously? While this variable at least takes a stab at incorporating the perception of pleasure into the PE
equation, it’s fundamentally flawed because only 30 percent of women achieve orgasm during sexual intercourse regardless
of how long their partners last.
A Good, Commonsense Definition of PE
So, who’s right? Maybe none of the above. Maybe all of the above. But that doesn’t matter. What matters is finding a
definition that is both broad enough and specific enough for any couple who hears it to say, “That’s it!” You can’t do that
with stopwatches. So where should we look?
“It’s not so much the length of time that matters,” says Derek Polonsky, MD, a psychiatrist in private practice in
Brookline, Massachusetts, “but the satisfaction for men and their partners.”
Urologist Michael Werner, MD, believes a man can have PE whether he lasts 1 minute or 5. For him, the matter
is simple: “If you spend the whole time during sex thinking about not ejaculating, that’s PE, and that’s not the way sex is
supposed to be.”
Thankfully, the World Health Organization (WHO) 2007 International Classification of Diseases gave us a pretty
good definition of PE that has nothing to do with thrusts or stopwatches: “The inability to control ejaculation sufficiently for
both partners to enjoy sexual interaction.”
That’s a definition everyone can work with because it takes into account the individual nature of not only everyone’s
physiological responses, but their psychological desires as well. Different people want different things in the bedroom at
different times. But everyone wants to be satisfied.
Research has shown that you can’t simply ask men if they’re satisfied with their staying power in bed. Their partners
need to be asked the same question. Why? Men tend to say they have issues when none exist, says Marcel Waldinger, MD,
PhD, a neuropsychiatrist at Leyenburg Hospital’s Haga Teaching Hospital in the Netherlands and one of the world’s leading
PE researchers. “The majority of men who complain of PE just aren’t satisfied with the way they have sex,” he says. “I call
these men premature-like ejaculators. They may have a psychological, cultural, or relationship problem.” But not necessarily
a PE problem.
Example: In 2009, Dr. Waldinger gave timers to about 500 couples in five different countries and asked them to time
themselves having sex. After they had sex on the clock for a month, Dr. Waldinger asked the men if they were dissatisfied
with their time to ejaculation. Almost 40 percent said yes. Then he asked if they’d be willing to take medication to make
themselves last longer; 23 percent said they would. The men who wanted drugs lasted an average of 4.9 minutes. The
average time for all 474 men in the study? Six minutes.
“There’s nothing medically wrong with most men, but so many think they have PE,” says Dr. Waldinger.
That’s why a man’s sex partner’s satisfaction must be taken into consideration as well as his own, because his selfjudgment may not be accurate. If his partner is satisfied with his staying power even though he isn’t, it’s hard to say there’s a
problem.
Ah, but if we go back to the WHO’s definition of one or both partners being unsatisfied?
It makes PE a judgment call based on each couple’s sex life—and PE then becomes a pretty simple matter of selfdiagnosis regardless of how many “minutes” or “thrusts” can be counted (and the rest of this book will show you how to
address the issue).
Meanwhile, this definition also lets us take direct aim at some of the biggest and most persistent sexual “endurance”
myths out there.
ENDURANCE MYTH #1: The best lovers go long
University of Vermont professor Gale Golden’s words are worth repeating: “There’s some cultural expectation that the
longer you last, the better you are,” says the author of In the Grip of Desire.
And yet different cultures have different expectations, as shown by the results of a 2002 survey by the
pharmaceutical firm Alza (owned by Johnson and Johnson). In the survey, American men said they should last about 14
minutes, but British blokes thought 10 was plenty, and German guys figured 7 was enough.
“The difference is that Americans receive less-accurate sex education but probably more exposure to glamorized,
inaccurate messages,” says Martha Kempner, MA, a former vice president at the Sexuality Information and Education
Council of the United States, a nonprofit organization promoting access to sexual-health services. “A guy in porn can
supposedly go at it for 45 minutes. That’s not realistic! Even if Europeans have the same cultural references to sexuality,
they have the education to break it down and realize it’s not real.”
ENDURANCE MYTH #2: She’ll only be pleased if you last all night
When we surveyed couples who typically have intercourse for about 6 minutes, only 34 percent of the men said that time
was satisfying—but 82 percent of the women said their sex lives were perfectly fine. That may not be a scientific sampling,
but it does reflect what PE experts like Stanley Althof, PhD, hear when they talk with clients.
“Everything can become so focused on how quickly the man ejaculates rather than on being loving and sensual,”
says Althof, a psychologist and executive director of the Center for Marital and Sexual Health of South Florida in West Palm
Beach. He says it doesn’t matter if a man lasts a minute or far longer: “If the man believes there’s trouble, he needs to talk
with his partner about it and learn what she wants.” (More on that in Chapter 6.)
ENDURANCE MYTH #3: PE is a young guy’s problem
Not true. This brings us back to the stopwatch thing again, but there is research breaking down how long men last by age, as
well as by some other interesting criteria. We’ll share some statistics, but we caution you against using these as measuring
sticks for your own sexcapades. Realistic measurements are hard to come by in a laboratory (you ever try having sex while a
man in a white lab coat holds a stopwatch?), plus we don’t believe you should be settling for average anyway. A better idea
is to use your past performance as a benchmark so you can set your own personal bests.
Okay, we’ve arrived at a good definition of PE. But we need to answer another question.
WHAT CAUSES PREMATURE EJACULATION?
That’s the eternal question isn’t it? Experts have debated the cause of PE and floated several possibilities.
Performance anxiety
You want to be her best lover. You know what to do, but when it comes time to do it, well, let’s just say that theory and
practice are two different things. The more you obsess about lasting longer, it seems, the quicker you come.
Overarousal
You think about sex with her all day. You go out for dinner with her that night. Afterward, you hit the couch, and then the
bedroom. By the time the big moment actually happens you’re so overamped that you go off like a short-fused firecracker.
Hypersensitivity
Some researchers think some men are simply hypersensitive to that kind of a stimulus and react, like sneezing at the mere
hint of pepper or pollen.
Boyhood masturbation
The theory here is that most young men, fearing being caught, masturbate quickly, unwittingly training themselves to
achieve gratification fast. “Weight lifters talk about muscle memory; I believe that premature ejaculators experience ‘penis
memory,’” says sex therapist Ian Kerner, PhD, author of She Comes First. (Read about his personal experience with PE in
Chapter 3.)
In today’s society, with media messages saturated with sex, the mainstreaming of pornography, and women
becoming sexually independent, all of these proposals have some credibility. After all, once a guy is in the bedroom and the
pants hit the floor, the pressure is on to deliver.
However…
What if PE was caused by something else? What if PE turned out to be completely normal and natural?
It may be true.
Conventional wisdom has always said that men reach their sexual peak in youth and women in middle age. The
problem for horny young men, of course, is that fatherhood demands more than just successful insemination. Humans
are not salmon, after all, where the male’s “care” starts and ends with the spilling of milt. Our newborns are helplessly
dependent on their parents—and for significantly longer than any other species on earth.
“So why do ‘men’ become capable of producing babies when they’re 12 or 13 years old, a decade before they can
reasonably hope to obtain and keep a mate, let alone be good fathers?” asks evolutionary biologist Richard Alexander, PhD,
of the University of Michigan. “And why is early male sexuality correlated with very rapid ejaculatory time? These two
things taken together suggest what has been called ‘sneaky copulation.’”
In early human societies, says Alexander, older, powerful men have traditionally taken practically all the women
for themselves. In that scenario, what do you do if you happen to be a younger, powerless man who has no women to mate
with? Well, your reproductive success depends on a furtive, “you’re quick or you’re dead” approach. If you have sex with
one of those “claimed” women, you’d better be quick, or you’re dead.
So fast ejaculation, in a sense, gives a man an evolutionary advantage when it comes to having as many offspring as
possible with as many women as possible.
How PE saved a caveman’s life
It’s also theorized that rapid release isn’t just handy for spreading your seed. That wham-bam-thank-you-ma’am type of
efficiency may also be a mechanism for calming male aggression. The fact that many primates ejaculate almost immediately
after intromission suggests that swift intercourse is a normal pattern and may have evolutionary survival value.
What exactly is the advantage of speedy sex? Look at the mating behaviors of our closest living relatives, the
monkeys and apes (actually, by these numbers, humans have, ahem, come a long way compared to, say, chimps).
Time Elapsed between Intromission and Ejaculation in Primates
SPECIES
Prosimians
Tree shrew
Lemur
Monkey
Rhesus
Baboon
AVERAGE
5 minutes
Less than 10 seconds
Multiple mountings lasting 10 to 20
minutes
Multiple mountings lasting more than
10 minutes
Apes and Homo sapiens
Orangutan
10.8 minutes
Gorilla
1.1 minutes
Gibbon
15 seconds
Chimpanzee
7 seconds
Homo sapiens
2 minutes
There is evidence suggesting that fast male orgasms in these species may be beneficial to both males and females—
and keep them all from killing each other.
In his seminal 1984 research paper, Lawrence K. Hong, PhD, a professor of sociology at California State University,
Los Angeles, remarked:
There appears to be an association between the speed of coitus and male aggression. Intermale violence seems more
likely to occur if the time between intromission and ejaculation is long. There was a time when the male protohominids
had marked variations in their speed of copulation; some could mount and ejaculate with haste. Since these protohominids
were less bothersome to their partners (females) and competitors (males), they were less likely to be rejected by the females
and attacked by the other males. In other words, because of their great speed, they were able to complete their copulations
before the females and the other males could effectively deter their actions.
With their ability to have fast sex, they also had more opportunities to get lucky with a greater number of females
within a given period of time. And what happened when they had a better chance at having more offspring? The kids
inherited their speed-sex traits. With less chance of incurring injuries for waylaying females, they might also have been able
to live longer. This would have given them still more opportunities to beget more offspring that possessed their speedy trait.
As this process continued from generation to generation, natural selection might gradually have produced more and more
males who ejaculated quickly in response to stimulation.
So imagine you’re one of the young, subordinate men in the social order. The only way you’re knocking up any
females is if you can have sex with them quickly and quietly so no dominant male has time to rip your head off.
Nature can be incredibly efficient, no?
And that may be the strangest part of this entire story. Back then, premature ejaculation was a valuable skill.
Nowadays? A dysfunction.
How Times Have Changed
If premature ejaculation was normal and advantageous in the past and is still common throughout Mammalia, why is it
labeled dysfunctional today? Even the term “premature ejaculation” has a negative connotation because it indicates bad
timing. How long a man can last in bed didn’t become a major clinical issue until a few decades ago.
Traditionally, the primary function of sex was procreation and the secondary was recreation. With this mind-set, the
pleasure a woman could experience was left out of the equation. Premature ejaculation was not a problem because it didn’t
diminish men’s orgasmic intensity, and women’s satisfaction was unimportant.
This began to change during the 1960s. The sexual revolution, mass availability of reliable contraceptives like the
Pill, and women’s heightened awareness of their individuality have rendered procreation a lower priority and dampened the
double standard with regard to sexual fulfillment. Women want to be satisfied.
Hence, a male’s reaching orgasm too quickly has come to be considered a problem. It makes both men and women
unhappy. This trait, which might have been a man’s best talent in prehistoric days, is now regarded as dysfunctional.
Well, this book is here to help. Read on and find out how you can have the best of the old and new worlds: sizzlinghot monkey sex that leaves you and your lover lying in a panting heap of sexual satisfaction.
CHAPTER TWO
THE HIDDEN SECRETS OF AROUSAL
Use them to your advantage (and hers)
You may think you know your orgasm pretty well after all these years: It feels grrrrreat! Uh, and it arrives too quickly. But
what happens before all the shooting starts? Most men really don’t have a clue, so a little biology lesson is in order. After all,
QUESTION: How long does the average guy last?
(The following is based on just one of dozens of surveys of men that have attempted to set a benchmark. Almost
every survey has gotten a different result.)
ANSWER: 5.4 minutes
BONUS ROUND #1: Average by age
18 to 30 years old: 6.5 minutes
31 to 50 years old: 5.4 minutes
51 years and older: 4.3 minutes
BONUS ROUND #2: Average by circumcision status
Circumcised: 6.7 minutes
Uncircumcised: 6.0 minutes
BONUS ROUND #3: Average by use of condom
Never: 5.1 minutes
Sometimes: 5.7 minutes
the first step in gaining better control of your ejaculation is getting to know your orgasm better, or, more specifically, the part
leading up to it. Bonus benefit: Understanding how her sexual response is different from yours can give you a major leg up
in satisfying your partner—it’s a secret the majority of men just don’t know.
Anatomy of Your Orgasm
In the 1960s, sex researchers William Masters and Virginia Johnson identified four phases in the human sexual response—
excitement, plateau, orgasm, and resolution. Remember them from 10th-grade human sexuality class? (Remember Mary
who sat in the third row? She was hot.) The phases describe a man’s sexual experience from beginning to end pretty
accurately. Let’s climb that ladder.
PHASE 1: Excitement
A kiss, a touch, an image, or even just the thought of Mary from the third row shimmying out of her panties is enough to
kick-start this first phase. As your brain processes these erotic stimuli, it sends signals to your body to prepare it for action.
Your muscles tense, your heart rate and breathing quicken, the blood vessels in your penis begin to relax and fill with blood
for an erection.
PHASE 2: Plateau
In this pre-ejaculation phase, your testicles are pulled upward toward your pelvis. Contractions in the smooth muscle in the
testicles, inside the ducts of the epididymis and vas deferens, in the seminal vesicles, and in the prostate begin to propel
semen forward into your ejaculatory duct system. Right about then, the area of your brain that registers pleasure fires up and
sends signals triggering even more bloodflow to your penis. You become diamond-tip hard. Pretty impressive, huh?
Next, pressure builds up behind a closed internal sphincter—a valve—creating a sort of pressure chamber in your
urethra. A different valve, the prostatic sphincter, keeps the seminal fluid from flowing backward into the bladder. The
chamber is filled; you’re locked and loaded. This is the point of ejaculatory inevitability, when even recalling Derek Jeter’s
career batting stats couldn’t halt your climax.
PHASE 3: Orgasm
Oh, yeah! Or, in the minds of speedsters, Oh, no! Either way, there is no turning back from this, the shortest of all four
phases. Something triggers a sudden opening of the sphincter valve and the seminal fluid is released. Simultaneously, the
pelvic muscles at the base of your penis begin rhythmic, involuntary contractions that help spurt semen, containing millions
of sperm, out of the urethra and the glans, the head of the penis. Immediately, the sphincter valve closes and the ducts fill up
again. The process repeats rapidly about five to seven times, once every 0.8 seconds or so.
PHASE 4: Resolution
The final phase, postejaculation, is when your heart rate, blood pressure, and muscle contraction return to normal. You may
continue to have a full or partial erection, but you cannot have an orgasm during this phase. If you are younger than 30, you
may be able to raise another erection within minutes to an hour or even stay hard after ejaculation. Older men experience
a much longer refractory period; it can normally take several hours or a full day between an orgasm and the ability to gain
another erection.
Delaying the Inevitable
Now that you know the biologic step-by-step process leading to the involuntary release—the point of no return—you’re
probably thinking, “So what? How’s that going to help me control something that’s involuntary?” Well, it will. Stick with
us. You see, by being able to better recognize when you are approaching that point of no return, you can, with practice, learn
how to delay reaching it so you can enjoy that “pre-coming” feeling longer. We’ll detail exactly how to accomplish this in
later chapters. But first, let’s investigate her orgasm and learn how arousal for females is often quite different from yours.
These secrets, which many men never take the time to learn, can be used to prolong the enjoyment of sex and give her the
most amazing orgasms she has ever had.
Anatomy of Her Orgasm
Those Masters and Johnson phases of sexual response apply to women as well, but women experience them in a much
different, less linear fashion. And much less rapidly. Consider this: Studies show that it takes between 15 and 40 minutes
for the average woman to reach orgasm. That timing discrepancy alone can create a “premature” situation for you. And it
can cause anxiety for her, too. Just as you are concerned about lasting long enough, so too are many women equally selfconscious about taking too long or being unable to orgasm through intercourse. Some will fake orgasm or go without it out
of embarrassment.
So, why are our arousal sequences lacking in synchronicity? Well, as we suggested earlier, evolution may have
something to do with it. Males and females evolved differently. This explains a lot: The area of the brain devoted to sexual
pursuit is two and a half times larger in the male than it is in the female brain, according to neuropsychiatrist Louann
Brizendine, MD, author of The Male Brain, an exploration of how men and boys think. Men are hardwired to be ready for
sex at every opportunity, she says. It makes sense from a purpose-driven standpoint: A male wants to sow his seed into as
many females as possible (and as quickly as possible just in case any dominant males—or even predators—are nearby, bent
on spoiling his good time) in order to ensure that his DNA survives into the next generation.
Mother Nature designed the female brain with a different agenda, a checks and balances system to deal with this
kind of primal male urgency. Because pregnancy and nursing are such dangerous and time-consuming duties, women
are generally far more thoughtful and selective about whom they mate with. The part of the brain that analyzes risk and
evaluates potential mates is larger in a woman than it is in a man. She’s not just making sure you’re physically attractive,
she’s looking for an emotional connection that suggests you’re the kind of guy who’ll hang around to protect and provide
for offspring rather than running off to the Monkey Bar. In fact, it appears that, for women, there’s an emotional requirement
that must be satisfied early on in that four-phase process. Equally important is a feeling of relaxation, comfort, and absence
of worry that signals a green light for her to orgasm.
You can see how Masters and Johnson’s linear model of sexual response can muck up expectations. Recent research
suggests that for at least one-third of all women, wanting to have sex doesn’t necessarily begin with desire, but rather
with some sort of cognitive motivation. There needs to be a reason to get sexual, and only after physical arousal is well
established does desire kick in. That may be one reason why plenty of hugging, kissing, and foreplay are so crucial to her
achieving orgasm.
During all that groping, kissing, and caressing, her nervous system starts taking notes and fires feel-good messages
through the web of nerves that weave their way through her pelvis and up to her brain. This early stage is where a lot of
women get tripped up because they can’t silence the voices in their heads long enough to focus on the sensations (When
was the last time I had a bikini wax? I hope the kids don’t hear us. Am I prepared for that 8 o’clock meeting? Does he think
my thighs look huge?). Research by neurologists at the University of Groningen in the Netherlands shows that the brain’s
amygdala and prefrontal cortex, which process fear and anxiety, need to be less active during sex in order for a woman to
climax.
If she’s relaxed and feels an emotional connection to you, she’ll become more turned on. Her breathing speeds up,
her heart rate increases, her breasts swell and the nipples become erect, and blood will continue to flood the pelvic area.
Around this time, the walls of the vagina start to secrete a lubricant in beads that eventually get bigger and flow together.
The more engorged she becomes, the more sensitive she is to your touch, causing the nerves to signal back to the brain
to pump more blood, creating an increasingly pleasurable loop, says Barry R. Komisaruk, PhD, an adjunct psychology
professor at Rutgers University and coauthor of The Orgasm Answer Guide. Then the lower part of her vagina narrows in
order to grip the penis while the upper part expands to give it someplace to go.
If all goes well (i.e., the phone doesn’t ring), an incredible amount of nerve and muscle tension builds up in the
genitals, pelvis, buttocks, and thighs—until her body involuntarily releases it all at once in a series of intensely pleasurable
waves. Oh yeah!
The big bang is the moment when the uterus, vagina, and anus contract simultaneously at 0.8-second intervals. A
small orgasm may consist of three to five contractions; a biggie, 10 to 15. Many women report feeling different kinds of
orgasms—clitoral, vaginal, and many combinations of the two. According to Beverly Whipple, PhD, coauthor of The G Spot
and Other Discoveries About Human Sexuality, the reason for this may simply be that different parts of the vagina were
stimulated more than others and therefore had more tension to release. Muscles in other parts of the body may also contract
involuntarily—hence the clenched toes and goofy faces.
After the peak of pleasure, the body usually slides into a state of satisfied relaxation—the refractory phase—but not
always. “Like their male counterparts, women can experience pelvic heaviness and aching if they do not reach orgasm,”
says certified sex therapist Ian Kerner, PhD. In fact, Kerner says, “many women complain that a single orgasm isn’t enough
to relieve the buildup of sexual tension,” which can leave her with her own “blue balls.” Don’t worry: Helping her get to
second and third Os is your opportunity to lengthen sex sessions and satisfy her needs. We’ll tell you how later.
Big O Blockers
So what goes wrong on those nights when the fuse gets lit but the bomb never explodes? “Nine times out of 10 it’s because
[the woman isn’t] getting enough continuous clitoral stimulation,” Kerner says. Often, “a woman will get close to orgasm,
her partner picks up on it, and [then he either] orgasms immediately or changes what he was doing.”
That’s why Kerner frequently recommends the woman-on-top position. Because she controls the angle and speed
of the action, it allows for the most constant clitoral stimulation. Another solution is to find a position that mimics how she
masturbates. If she has solo sex by lying on her belly and rubbing her clitoris with her hands tucked beneath, then you might
enter her from behind in that position. By watching her masturbate, you’ll get a better sense of the stimulation she needs.
“Spectatoring” is another problem that can trip up women. “It’s when a woman is too concerned with her appearance
and/or performance to actually enjoy herself,” Kerner says. There’s no way she is going to have an orgasm if she’s fretting
about her cellulite. That’s why it’s crucial that you praise her body often (especially outside of the bedroom) and tell her how
sexy she is. It’s also why foreplay is so important. (Later on, we’ll help you treat her to all-day foreplay, which will help you
last longer while priming her for incredible multiple orgasms!) “It may seem counterintuitive,” Kerner says, “but [she] needs
to relax to build sexual tension.”
CHAPTER THREE
HE CAME. HE CONQUERED.
How one man beat PE
By Ian Kerner, PhD, certified clinical sexologist
When we last left Kerner at the beginning of this book, his fiancée had just given him an ultimatum: Fix his PE by the time
she returned from a business trip abroad, or the engagement was off. As the clock ticked, his anxiety intensified…
Premature ejaculation has been, without a doubt, the single greatest factor in the formation of my character. Whenever
someone asks me why I pursued a PhD in clinical sexology and became a sex therapist, I always say it’s because of my
struggles with PE and the years of quiet desperation I endured.
I still remember when my college girlfriend first went on the Pill. I was terrified. Until then, a condom lined with
lidocaine (a numbing agent that rendered me barely able to feel my penis) had been my first line of defense.
The sex wasn’t pleasurable, but at least it wasn’t totally humiliating. Now, however—could I go it alone? The first time we
made ungloved love, I was overwhelmed by the sensations: the slippery warmth, the wetness of being inside her. It felt so
amazing; I wanted desperately to savor the experience. But it was out of my control. On my very first thrust, I went in, but I
didn’t make it out. And as I laid on top of her—defeated, depleted—I cried.
I wanted to make love like a man, but I was a little boy, incapable of controlling my bodily functions.
I considered premature ejaculation my tragic downfall and believed myself cursed with an Achilles penis. Today, at least I
know I’m not alone. Indeed, whenever I see a commercial for sildenafil (Viagra) or one of its competitors, I get ticked off:
Why isn’t the media talking about PE? According to urologists Andrew McCullough, MD, of the New York University
school of medicine, and James Barada, MD, formerly of the Albany College of Medicine, PE is the number one sexualhealth problem affecting men, and it is three times more common than erectile dysfunction (ED). Estimates vary, but 20 to
30 percent of men are thought to experience PE—and those figures are based on self-reports.
What do women say? Nearly two-thirds of them have had sex with a man who experienced premature ejaculation, according
to a recent survey of 900 women conducted by MensHealth.com and Cosmopolitan magazine. PE strikes men of all ages,
and the condition affects virtually all men at some time in their lives. Dr. McCullough and Dr. Barada surveyed more than
1,100 men with PE and found that those men report less satisfaction and more anxiety about their sexual relationships. It can
wreck their confidence and cause them to avoid new relationships.
The Sensitive Man
At first, like any overexcited teenager, I dealt with PE in the usual ways: masturbating before going out on dates (which
helps, but becomes less effective as you get older and require more downtime between erections); downing beers; and
donning double, even triple condoms. I even tried to delay orgasm in the heat of the moment by distracting myself with
baseball statistics or images of dead people—and let me tell you, thinking about corpses during sex is a definite mood killer.
Later, I graduated to herbal remedies, topical ointments, and miracle creams advertised in the backs of porn
magazines. On one occasion, my little experiments led to an acid burn of my penis in the men’s room of a Japanese
restaurant.
In yet another doomed effort, I put the Errol Flynn method to the test: a dab of cocaine on the tip of the penis. The
matinee idol once explained that it could be helpful “if you’re quick on the trigger.” But it didn’t work for me, and I doubt it
really worked for Flynn. He claimed to have slept with more than 13,000 women in his lifetime. Now, how the hell are you
going to do that without being a premature ejaculator?
Am I Coming or Going?
The day Tara, my fiancée, left for Hong Kong—giving me 3 weeks to shape up or clear out—I spiraled to an all-time low. In
a desperate attempt to keep that ring on her finger, I tried every type of radical therapy. There was biofeedback treatment, in
which an electrode was inserted where I least wanted it and I was encouraged to engage in an activity once thought to cause
blindness in teenagers; self-hypnosis tapes that lulled me into such a deep trance with their sounds of water being stopped
and started that I woke up soaked in my own urine; and a session with a German “masturbation specialist” who sternly
observed and critiqued my methods of self-pleasuring, all the while keeping time with a metronome and commanding me to
“stop, start, squeeze; stop, start, squeeze!”
By the time Tara returned, I was a complete mess. I didn’t know if I was coming or going. Or, for that matter, if I’d
be coming and then going after having sex with her.
And as she emerged from the shower and came to bed, naked and glistening, I was so nervous, I didn’t just
prematurely ejaculate, I spontaneously ejaculated.
True to her word, she left me. Don’t feel bad. I don’t (anymore). And don’t worry, either. According to
the MensHealth.com and Cosmopolitan survey, less than 10 percent of women say they’ve dumped a guy because he was
quick on the draw.
Shortly after we broke up, I began working with a really terrific sex therapist. I overcame PE within a few months
by using six techniques. [See Chapter 4 to learn many of the techniques that Kerner used to achieve success.] I was so
transformed, and inspired, that I decided to change careers and go down that path myself.
Today, I continue to learn about PE. My struggles led me not only to my passion in life—writing about sex and
helping others through sex therapy—but also to the love of my life: my wife, Lisa. My short story finally found a happy
ending.
Ian Kerner, PhD, is a certified clinical sexologist and the author of She Comes First: The Thinking Man’s Guide to
Pleasuring a Woman.
CHAPTER FOUR
THE PE PLAYBOOK
Your arsenal of advice for negotiating a cease-fire
If there was an easy remedy for PE, you probably would have figured it out for yourself by now and wouldn’t have a need
for this book. But there is no instant, once-and-done, works-every-time fix. You’re dealing with an involuntary mechanism
influenced by a myriad of physical and psychological moving parts that not even the thought of your aunt Bea’s sagging
bosom poking through her nightie could stop. However, there are many strategies that can help you in your quest to last
longer than you do right now. Some work better than others. Some you’ll just have to try for yourself.
But first, four common home remedies that probably aren’t worth your effort.
Distraction Tactic #1: Baseball stats
Sex is part body, part brain. So in the heat of passion, some men think about baseball stats, others think about roadkill, and
still others about John McCain. “It works because you’re less sexually present,” says psychologist Barry W. McCarthy, PhD,
coauthor of Men’s Sexual Health: Fitness for Satisfying Sex. But beware: If you picture something disgusting or morbid,
you’ll train yourself to think that way during sex—and that in itself can lead to erection problems, he says.
Distraction Tactic #2: Timed imbibing
You may have already tried this old trick. While having a drink or two before sex may relax you and depress your central
nervous system enough to delay ejaculation a bit, don’t rely on it. You could become sexually dependent on alcohol and then
develop erectile dysfunction when sober. And then there’s the real risk of having too much to drink and being unable to raise
an erection, which doesn’t do anyone any good.
Distraction Tactic #3: Pre-sex orgasm
It’s the most obvious move: Go it alone first a few hours before having sex and you may last longer in round two, depending
on your natural refractory period.
But there’s a downside, says McCarthy: Second orgasms are less intense.
However, if you have a moderate refractory period, you may find that morning masturbation will dial down your speedy
excitement at night. This isn’t a fail-safe approach. Older men, for example, may find that their second erection isn’t as easy
to achieve and maintain, and you’ll have better results if you use masturbation to train yourself to recognize your sexual
response and master your domain. (More on exactly how to do that in Chapter 5.)
Distraction Tactic #4: Condoms
Wearing a condom can reduce the level of stimulation from a slippery vagina that causes a man to come too quickly. Some
men find that wearing two condoms allows them to last longer, though the downside is less pleasure for them. And it can
create an awkward transition between arousal and intercourse.
Now for some techniques that will probably be much more helpful than “distractions” are for men with occasional rapid
ejaculation and those with lifelong PE.
Flex your sex muscles.
Exercising the muscles of your pelvic floor isn’t something you go to the gym to do (unless you want to draw strange looks
from the Zumba class), but it can be good for your sexual health by building firmer erections, more powerful ejaculations,
and even increased sexual stamina. Some men find that by monitoring the tension of these muscles, they gain greater control
for delaying ejaculation.
The specific exercises are called Kegels, named after gynecologist Arnold Kegel, MD, who prescribed them to
women to remedy incontinence following childbirth in the 1940s. Now they help both women and men enjoy more intense
orgasms. And for many years sex therapists have recommended them to men with premature ejaculation, with varying
degrees of success. The theory is that Kegel exercises will help a man strengthen the muscles involved, become more
aware of the feelings in his penis and pelvic floor, and ultimately improve his ability to relax the muscles and prevent an
ejaculation.
To do Kegels, you squeeze your pubococcygeus muscle, or PCs for short. How do you find this love muscle of the
pelvic floor? Take a whiz—then stop midstream. You’ve found it! To strengthen it, contract it for 5 seconds, then relax for 5
seconds. That’s 1 repetition. (Note: Don’t actually do Kegels while taking a leak, which could cause urological issues; that
was just to help you identify the muscle.) Do 10 at least three times a day. Keep your abs and glutes out of it—no clenched
butt cheeks or flexed abs, says Debby Herbenick, PhD, a sex research scientist at Indiana University and a Men’s Health
Bedroom Confidential columnist. Doing so may actually have the opposite effect.
As you become more proficient after a few weeks of practice, try holding the squeeze longer, for up to, say, 10 or 15
seconds. Then alternate between 3-second squeezing and relaxing periods. You can practice your Kegels anytime—driving
a car, watching TV, sitting in a staff meeting—because no one can tell. You can also do them while masturbating. You may
notice your erection jumping and your testicles moving as you squeeze your pelvic floor. Stand and drape a small, dry
facecloth over your erect penis to add resistance for the lift. Yachtsmen can attach a small flag and practice their semaphores!
Be creative in your Kegel practice, matey.
A modified version of pelvic pushups may work even better for some men. This one exercises a specific pelvic floor
muscle called the bulbocavernosus (BC). “When this muscle contracts, nerves send a signal up your spinal cord to suppress
arousal and keep you going longer,” says Darius Paduch, MD, PhD, an assistant professor of urology at Cornell University.
To find the BC, lay naked on the floor with your legs bent and your feet flat on the floor and place your fingers on your
perineum, which is between your scrotum and your anus. Try to flex the muscle there gently. That’s the difference between
BC and PC exercises: They are done much more gently than Kegels. You may feel a slight tug at the base of your penis if
you’re doing it right. (If you feel your belly or anus contract or your legs move, you’re squeezing the wrong muscle and
too tightly.) Hold the contraction for 5 seconds, then allow the muscle to completely relax before flexing again. Now begin
masturbating. When you’re about to reach orgasm, flex your bulbocavernosus. Once you get the hang of it, flex during sex.
“This won’t bring you from 2 minutes to 20 minutes, but you can definitely progress up to 5 to 7 minutes,” says Dr. Paduch.
Learn the Valsalva maneuver.
Sounds very Kama Sutra, no? Maybe, but it’s not. When you feel like you are on the verge of coming, hold your breath
and bear down as if you are trying to have a bowel movement. (Um, please don’t actually have one.) “Increasing your
intraabdominal pressure relaxes the muscles that contract during ejaculation,” says Dudley S. Danoff, MD, a urologic
surgeon at Cedars-Sinai Medical Center in Los Angeles. “You can actually get a few more minutes.” (The technique can be
used effectively in conjunction with the classic PE remedies, the start-stop and squeeze methods described below.)
Try a numbing condom.
Topical anesthetic creams like benzocaine (called a male genital desensitizer) reduce sensation in your penis so you can last
longer. But they also numb her vagina, something no man needs. A better option is a condom coated on the inside with a
lube containing benzocaine, like Trojan’s Extended Pleasure and Durex’s Performax, so she’ll be able to reach an orgasm
while you are held back. They can prolong erection time by 3 to 8 minutes, says Herbenick. “That’s usually enough of
an extension for many men—and women—to feel good about.” The drawbacks of these climax-control condoms are that
you’re deadening your own pleasure and focusing on the mechanics of sex rather than the intimacy of it. But judging from
the brisk sales of these condoms, many men are more than happy to sacrifice for longer thrusting. And some find that a few
numb rounds of longer sex are all it takes to get into the groove of lasting longer naturally.
Have morning sex.
Many PE sufferers report being able to last longer when they have sex shortly after awaking. A night’s sleep dials down the
sympathetic nervous system. You may be more relaxed and in control.
Mix it up.
The longer you spend in one sex position, the less control you’ll have over ejaculation. Try switching from position to
position—sort of like sexual channel surfing. Chances are, you’ll be able to last two or three times longer than normal. In a
study at the University of New Brunswick in Canada, researchers found that men who frequently changed sexual positions
were better able to delay ejaculation than those who used other methods to try to stall.
Go slow.
Resist the urge to thrust fast, hard, and deep in a repetitive one-two pattern, a surefire way to fire too soon. Pistonlike pornmovie thrusting feels horrible, women say, and can leave a girl dry, sore, and bored. Vary your thrusts, adding side-to-side
movement or grinding pelvic pressure against her clitoris when you’re all the way inside of her to change up the stimulation.
Start with mostly shallow thrusts that target the first third of the vagina—the most sensitive part—but don’t create too much
stimulation on the head of your penis. As her arousal builds, add a higher ratio of deep thrusts. Go in slowly and come out
quickly; the fast withdrawals will create even more stimulation on the clitoris—with no substantial penalty for you.
Let her climb on top.
The classic missionary and rear entry (doggy style) are the worst positions for men with PE because they are so erotically
stimulating. When she’s on top, however, your penis is less stimulated and it’s easier to relax your pelvic floor muscles.
Lie down with your legs together. Have her straddle you, with her knees on either side of your torso. Ask her to
go slowly—long and fast thrusting is hazardous to a man’s endurance. Encourage her to be creative up there. Suggest that
she move in circles instead of up and down. Or have her lean forward until her clitoris comes into contact with your pubic
bone. Both techniques will increase stimulation for her without driving you completely wild. She’ll approach orgasm more
quickly, while you’ll be able to catch your breath (and enjoy the show). See “Four Positions for Last-Longer Sex” below.
Take your balls out of play.
As you’ve probably noticed, the testicles are filled with lots of nerve endings—a bad thing when you’re playing ice hockey
and a puck hits home, but a wonderful thing when you’re body checking her. Positions that stimulate them (again, like the
missionary or rear-entry positions, where they brush—or bang—up against her body) may give you a little more stimulation
than you can handle. Switch to a position that takes the testicles away from the action—another reason to have her take the
top position and lean forward.
Give yourself a break.
In other words, don’t be so hard on yourself. You’re not the only one who has experienced sexual problems. Try not to blame
yourself or feel inadequate because anxiety compounds performance stress, which doesn’t help anything. Performance
anxiety is about the fear of being judged or not living up to expectations. But its effect on the body is the same as if you
were being mugged in a dark alley. The body is programmed to see anxiety as a threat, and the nervous system triggers
the fight-or-flight response, sending out chemicals to protect us: The heart races, muscles tense, and blood is shunted from
the hands, feet, and penis to the large muscles of the shoulders and hips so we can fight or run away. How can you expect
to relax and have great, long-lasting sex when your body is primed to kick some ass? One of the best things you can do
to reduce that secret anxiety is to talk openly with your partner to avoid miscommunication and share in employing the
remedies for PE. Now, we understand that you may feel uncomfortable doing that. So if you are experiencing feelings of
extreme guilt, anxiety, or frustration about your PE and you can’t talk to your partner, talk to your doctor or consider seeking
behavioral therapy or sexual therapy.
Try an SSRI.
As we mentioned earlier in this book, your doctor can write a prescription for the off-label use of a type of antidepressant
medication called an SSRI, or selective serotonin reuptake inhibitor. Studies indicate that men with PE tend to have lower
levels of serotonin. By raising the level of serotonin in the brain, SSRIs like fluoxetine (Prozac) and sertraline (Zoloft)—as
well as the tricyclic antidepressant clomipramine (Anafranil)—can delay orgasm. And their antianxiety effects may also
help remedy PE-related mood disorders like depression. In one review study, fluoxetine was shown to increase mens’ holdoff time threefold. Another SSRI, paroxetine (Paxil), increased the time eightfold, but that drug comes with a higher risk of
side effects, such as drowsiness and nausea. The best scenario may be that an SSRI helps a man last long enough to gain the
sexual confidence to more effectively use the awareness exercises below. See our full list of PE drugs and their side effects
below.
These drugs require a prescription and usually take several weeks of daily use to be effective, which is why
drugmakers are eagerly exploring medicines that can work on demand. (See “Where’s My PE Pill?”)
Practice start-stop or squeeze.
Most sex therapists believe the best course of action for beating PE is to habituate to the sexual stimulation of intercourse.
Two similar behavioral techniques—“start-stop” or “faster-slower” and “squeeze”—have been recommended for decades.
Both are pacing methods that work by helping a guy who ejaculates prematurely become more aware of his body and the
feelings preceding orgasm so he can learn to back off before the point of no return. In start-stop, when you feel yourself
nearing orgasm, slow down or stop thrusting until your sexual tension diminishes (it takes about 15 to 20 seconds), then
continue. Squeeze involves having you or your partner squeeze the head of your penis to thwart orgasm. Just before you
reach the point of no return, squeeze right below the head with a thumb and index finger, focusing the pressure on the
urethra—the tube running along the underside of the penis. This pushes blood out of the penis and momentarily represses
the ejaculatory response.
You can practice this by masturbating along with her in bed or by having her pleasure you by hand or orally. Just
give her the signal to stop or squeeze if you are reaching your threshold. By the way, don’t be shy about asking your partner
to lend a hand. In a Men’s Health survey, 98 percent of women said they’d be happy to help their partner last longer. The
downsides are that both methods take some practice, which may turn the sex into more of a mechanical exercise than an
intimate experience. But they can be effective for some men, especially when used with other strategies, such as progressive
masturbation exercises, to control the level of stimulation.
Take a break.
When you feel yourself approaching your point of no return, treat this feeling as a cue to slow yourself down and bring her
up to speed. What you do depends on you. Sometimes it’s enough to stay inside her but simply stop moving and lie still. Or
pull out and do something else entirely. Many men think of oral sex as something they can do only before intercourse, but
there’s no rule that says your tongue can’t revisit a favorite stomping ground. And if she protested when you pulled out, use
one hand or your tongue to stimulate her clit while the fingers on the other hand sub in for your recovering penis.
Another time-out alternative is for you both to please yourselves. This is a lovely thing to do, for any reason. It gives
you a chance to look at her, and to watch how she touches herself and gives herself pleasure. At the same time, it’s a more
controlled situation, so you can touch yourself only at the rate you know you can tolerate while her experienced fingers play
catch-up.
Master masturbation.
While stimulation training as a team effort is an effective approach, we understand that a man may be hesitant to elicit his
partner’s assistance, especially early in a relationship. So a guy can use solo versions of start-stop or squeeze in private.
Progressive masturbation, also called peaking exercises, for building sexual stamina is sort of like working out on a
treadmill. Every time you do it, you try to go a little longer until you can attempt a 10-K.
“Label your arousal level on a 1-to-10 scale, where 1 is no arousal and 10 is ejaculation,” says sex therapist Barbara
Keesling, PhD, author of Sexual Healing. “Have your partner stimulate you [or do it yourself] to a 3; then let the peak go
down. Next, go to a 4, then back off, and so on. Relax and focus on the sensation.” See Chapter 5 for more details on how to
use masturbation to train yourself to last longer.
Relax, breathe from your belly.
You can also increase your stamina by reducing your abdominal muscle tension, says Marc Goldstein, MD, professor of
reproductive medicine and urology at Cornell University’s Weill Medical College. The best way to do that is to breathe
from the belly. That means stop sucking it in. Let it all hang out. Breathing deeply and slowly does two things: (1) It calms
the nervous system, which is helpful when you’re trying to pull back from the brink, and (2), it circulates the sexual energy
concentrated in your genitals throughout the rest of your body. This not only helps to delay orgasm, but also makes it much
more powerful when it finally happens. The problem is that most men are chest breathers. They take short, quick breaths,
especially during the excitement of sex. But you can learn to go deep and slow. Try breathing so that your belly rises before
your chest does. That ensures deep breaths and it also takes your mind off worrying about ejaculating. Try it while practicing
the start-stop and squeeze methods (described above) as you masturbate. A yoga-style breathing technique may help, too. To
learn it, see Chapter 10.
Try intercourse acclimatization.
Sounds like part of a NASA launch sequence, but it’s actually a lot more fun. You enter your partner’s vagina and quietly
rest there for a few minutes as your penis acclimates to the feeling of her warm, wet insides. What to do in the interim?
Talk, sing, play 20 questions, hey, how about kiss? Move around only enough to maintain your erection. No bump and
grind. Think of it as what a climber does at basecamp before attempting to summit Everest. Sex researchers say that
acclimatization, a sort of “sexual dullness,” occurs after about 7 to 10 minutes. Then your penis will be able to tolerate
thrusting and enjoy more intense pleasure while you learn to manage your arousal.
Practice your short game.
Here’s another, more proactive way to habituate to contact with her vagina, one she’ll enjoy immensely. After she’s
sufficiently aroused through oral sex, ride the shaft of your penis through the lips of her vulva, stimulating her clitoris but
never entering her. Do this for a few minutes, then press the end of your penis into her clitoral head. Rub your glans against
her clitoris. Linger in her vaginal entrance, where the most-sensitive nerve endings are. When you do have intercourse, focus
on small, shallow movements that penetrate the first 2 to 3 inches of her vagina. When you recognize that you’re getting
close to coming, pause and regain your composure.
Don’t think about coming.
Easier said than done, we know. And yet, it makes sense. “There’s a Hungarian proverb that says, ‘Do not paint the devil on
the wall, for it will appear,’” says Agnes Beregszászi, a sex columnist in Hungary. Translation: When you’re thinking about
coming, the area of the brain responsible for triggering orgasm is engaged whether you’re trying to have one or halt one. So
stop thinking about it. How? Focus on what’s going on with her instead. “Good sex is like driving to a faraway city,” says
Beregszászi. “You know your destination, orgasm, but you need to concentrate on the road ahead of you—turn left here,
turn right there. If you focus on what is happening now—her silky thighs on your hips, say—you can diffuse your pleasure
throughout your whole body.”
Let her go first.
Women’s innate capacity to experience multiple orgasms is a boon to men, especially those with PE. When you help her to
her first one, it relieves you of some of the pressure to please and the psychological anxiety that feeds into PE. Start foreplay
with sensual massage. Then use your fingers and mouth to bring her to the peak of orgasm and leave your dick out of it.
Many men with PE become so talented at oral sex that they end up giving their lovers better orgasms that way than they
could with intercourse. Once you’ve treated her to her first orgasm, others will require less time and effort. In all likelihood,
you’ll be able give her another one through intercourse and time it to coincide with your own. Chapter 7 will cover how to
prolong foreplay, take your time with intercourse, and enjoy afterplay for a long night of amazing sex.
Four Positions for Last-Longer Sex
Positions that emphasize fast, in-and-out thrusting and have your bodies touching almost exclusively at the genitals are the
ones that most men find the most visually and physically stimulating. No wonder they’re also the positions many men have
the most difficulty holding back in.
To give yourself a better chance for longer-lasting intercourse, try a move that can diffuse the stimulation throughout
your body with head-to-toe touch. Another benefit of these four sex styles—the CAT, the spoon, the side-by-side, and the hot
seat: Women love them because they require ultracloseness that’s romantic and intimate.
The CAT
CAT is short for coital alignment technique. This sort of bodywork is much like the missionary position, but it’s easier on
you because your pelvis is pressed down and you’re higher on her body. It also benefits her: She can bend her legs and tilt
her hips up or wrap her legs around yours. This causes the base of your shaft to maintain constant contact with her clitoris
as you grind against each other. In one study in the Journal of Sex and Marital Therapy, women who were unable to have
orgasms in the missionary position reported a 56 percent increase in orgasm frequency using the coital alignment technique.
Other studies suggest that up to 73 percent of women can achieve orgasm with CAT.
Now try this: Ask her to stretch out her legs under yours. Instead of thrusting up and down, rock forward and back
and grind your pelvis in a circular motion to rub your pubic bone against her clitoris. The grind reduces your friction and
amps up hers. All good.
Spoon
This tame position is ideal for long sessions because it’s so comfortable and you can focus on stimulating her with your
hands while avoiding the rapid and deep thrusting that’ll bring an end to the fun. You both lie on your sides facing in the
same direction. She bends her knees and pushes her butt back toward you as you enter her from behind. Adjusting the lean
of your bodies will vary the angle of entry and help with the rocking motion.
Now try this: To give her the sensation of greater width inside her, have her move her top knee up toward her breasts.
Adjust your position so you are more on top of her top hip than behind her. If you are on her right hip, for example, gently
insert your right thumb into her vagina to give her the sensation that your penis is thicker while you use your index finger to
rub her clitoris.
One more benefit of spooning sex: It’s a comfy position to fall asleep in afterward.
Side-by-Side
Many men find that they can last much longer before climaxing in this facing, side-lying position than in most others. It also
allows for intimate eye contact, kissing, hugging, and touching. You both lie on your sides facing one another. She lifts her
top leg so you can enter her more easily. With your legs entwined like scissors, you both get a break off your knees.
Side-by-side is also a good for femoral sex, or sex without penetration, a useful technique for men learning to stave
off ejaculation. Instead of entering her, rub your erection between her thighs or between her labia like a hot dog in a bun.
(More on femoral sex techniques in Chapter 7.)
Now try this: Wrap your arms around one another and kiss deeply while moving your hips slowly back and forth
toward one another.
The Hot Seat
It’s easier to relax your PC muscles in this female-dominant position, and it also allows you to start out stimulating her
through outercourse, or non-insertive sex. Sit on the edge of the bed or in a chair without arms and have her sit on your lap
facing away from you. Grab your penis and press the shaft against her clitoris, moving it from side to side or moving your
head in tight circles around it. You can do this for a long time as you build toward her orgasm. Try doing shallow, brief
insertions by having her shift a little more toward your knees. You can always pull out and squeeze your penis to stave off
ejaculation whenever you feel the need to, and then return to outercourse or intercourse.
CHAPTER FIVE
THE DO-IT-YOURSELF CURE
Relearn a handy technique for going the distance
“Know thyself.”
The ancient Greek aphorism, emanating from the Oracle of Delphi, historically has nothing whatsoever to do with
premature ejaculation. But it serves as a perfect theme for this chapter because knowing your sexual response and path to
ejaculatory inevitability is your most powerful technique for overcoming rapid ejaculation.
If you experience PE, you know that it sort of just happens. It seems out of your control. But it’s not. Doctors and sex
therapists say you can manage it by paying closer attention to what’s happening, to the feeling of arousal as it builds toward
that point you know all too well, the point you can’t seem to control.
Masturbation makes it easier to use those sensations to train yourself to last longer because you don’t have another
person in the room to worry about. It’s only you, big guy, and your hand.
Let’s invoke another maxim: Practice makes perfect. And what is masturbation if not practice for sex? Most of us
have quite a bit of experience in “tickling Yoda behind the ears” or whatever masturbation euphemism you’d like to use. But
there are right ways and wrong ways to do it if your goal is to train yourself to last longer.
The ancient Chinese referred to masturbation as self-cultivation and viewed it as a way to get in shape for the main
event. That’s exactly what we are talking about here—getting in shape.
Pinpoint the Moment of Inevitability
As we noted in an earlier chapter, Masters and Johnson broke the sexual response into four phases: excitement, plateau,
orgasm, and resolution. The part you need practice with is the second one. Most men don’t know how to enjoy staying in
that plateau phase and bang right through to orgasm. And men who are premature ejaculators never have intercourse for
long enough to habituate to the in-and-out sexual stimulation. That’s what this exercise aims to do: Help you slow down that
process and recognize the entire spectrum of feelings as you build to the point of ejaculatory inevitability. If you can learn to
tolerate increased levels of sexual sensations, then you will likely be able to hold off before coming so quickly during sex.
Rules of Engagement
You no doubt have your favorite way to go about going solo, but for now, follow these rules. The idea is to get really
intimate with the experience like you never have before.
• Give yourself an adequate block of time without distractions, at least a half hour. Lock the door. You don’t
need the anxiety of worrying that someone will walk in and catch you red-handed.
• Don’t use pornography to get yourself excited at first. Visual cues trigger dopamine transmission and can
speed up the process you are trying to delay.
• Use a dry hand. Avoid using a lubricant. The slippery stuff can speed up stimulation, but you’re going for
control.
• Don’t expect instant results. Just like building your biceps or sculpting your abs, learning to delay orgasm
takes time and effort—easily a few weeks. But, hey, it’s a lot more fun than doing chinups.
Rely on your imagination and fantasize your way to an erection. Use the physical friction of your dry hand to raise
the tide of sensations. Focus on the feelings and rate your sexual excitement on a scale of 1 to 10, where 9 is the point of no
return and 10 is orgasm.
Think of it as calibrating your penis, putting a number on your stimulation level so you’ll be able to recognize it
during intercourse. Premature ejaculators often go from, say, a 4 to a 10, skipping the levels in between. Your objective is
to experience those other stages. Practice bringing yourself to level 6, then 7, then as the sexual tension nears 8, slow down
your stroke, trying to keep yourself at level 7. Recognize how your body feels during all the stages of stimulation—and
not just your penis, but also your testicles, your breathing, your heart rate, your head, chest, butt, and shoulders. This is
Where’s My PE Pill?
A drug to fight premature ejaculation seems to work, but it’s unclear when it will become available—if ever. A
new study of 2,000 men with PE found that a form of antidepressant tripled the length of time men lasted during
intercourse. The drug, dapoxetine (Priligy), is similar to antidepressants like sertraline (Zoloft) and paroxetine
(Paxil). These drugs, called selective serotonin reuptake inhibitors (SSRIs), delay ejaculation, but they can also
lower your libido, which kind of defeats the purpose. Dapoxetine enters and leaves a man’s system more quickly
than those SSRIs do, largely avoiding that side effect, says Jon Pryor, MD, a Men’s Health urology advisor and the
study’s lead investigator. In the placebo-controlled study, men who took the pill increased their time to ejaculation
from less than a minute to nearly 4 minutes, on average.
Recently, Johnson and Johnson began selling Priligy in several European countries, including the United
Kingdom. In clinical trials, men who took 30 mg of the drug increased their time to ejaculation from 1 minute and
45 seconds to more than 2 minutes and 45 seconds. Men taking 60 mg lasted more than 3 minutes. Another study
of 2,600 patients found that the medication increased the time a man could last to between three and five times
their normal. Because of the much shorter time that dapoxetine stays in the body compared to other SSRIs, it’s
ineffective as an antidepressant but may be useful to men who take the pill only when they expect to have sex. The
drug is not currently available in the United States. The FDA rejected Johnson and Johnson’s application in 2005,
but the company plans to present new studies in future discussions with the agency.
total-body learning. If things heat up too quickly, back off to a 5 or 6 if you must; your goal is to practice for 15 minutes.
Then bring yourself back to 7 and then near 8, but don’t let yourself ejaculate until the time is up. You may produce a few
drops of pre-come. This is a fluid released by the Cowper’s glands prior to ejaculation. That’s okay. Slow down to ease the
sexual tension and start another cycle of building tension. If you feel yourself about to come, try the squeeze technique
we mentioned earlier: Squeezing the head of the penis forces some of the blood out of your member and can forestall
ejaculation. Masturbate this way for 3 or 4 days, each time learning to bring yourself closer to that point of no return without
going past it.
When you are consistently able to bring yourself to the brink and then dial back with confidence, try using a
lubricant during masturbation to elevate the degree of stimulation. For variety, practice keeping your hand still and using
pelvic thrusts without squeezing your buttocks. Squeezing your butt can have the opposite effect of what you’re after. Give
yourself a few more days of practice with a lubricant, then when you are confidently able to cycle between nearly coming
and slowing down, practice with lube and porn to boost your physical stimulation even further with the tactile and visual
stimulation. See how close you can push yourself to the edge without going over. Time how long you can keep this up
beyond those 15 minutes. As a bonus, you’ll notice a big difference in the intensity of your orgasms. And, with a little more
practice, you should be ready to practice these same skills when you’ve got company.
CHAPTER SIX
HELP HER HELP YOU
The more you do this, the more you’ll do it
Let’s start with a question we know the answer to: If your partner had a problem that really bothered her, something that she
was keeping to herself, wouldn’t you want to know about it so you could try to help her? Of course you would. It’s not only
that you’re a caring guy who’s eager to assist, but also that knowing what’s up beats the heck out of guessing wrong.
Well then, why would you expect your partner to react any differently when something was concerning you? Most
women, if you haven’t figured it out yet, are rather understanding creatures who respect and value honest talk, so don’t be
afraid to take advantage of their considerable talent for listening. Talk about it. The alternative, suffering in silence out of
pride, can actually compound your PE problem.
“Not talking about premature ejaculation only raises anxiety, which can further affect performance when you’re in
bed,” says Paul Coleman, PsyD, a psychologist and the author of We Need to Talk.
Talking about it might be a little awkward for you, but it won’t freak her out. Consider this: In a recent Men’s Health
poll of Women’s Health magazine readers, 96 percent of respondents said they would be comfortable talking about PE and
helping out—as long their partners brought it up first.
“Own it. You don’t need to apologize, but say, ‘I have this difficulty, and it’s frustrating,’” says Stanley Althof, PhD,
a psychologist in West Palm Beach, Florida. The more you open up, the more she’ll talk with you about it.
Learn Her Needs
Men and women perceive PE differently, so don’t expect her to see things exactly the way you do, Althof says. If you last
several minutes, she may not even think there’s a problem. But if you last a minute or two, she may see you as selfish. So
after you tell her how you feel, ask what she wants—not in terms of time, but what turns her on, what she likes best, what
makes her feel good. Here’s one she probably never heard from a man before, even you: “What makes you feel loved?” We
think you’ll be surprised by the useful things you’ll learn by talking, asking the right questions, and listening.
Remember what we said about the differences between the male and female sexual responses back in Chapter 2?
Men can quickly become aroused and ready to have sex. All you need is a glance at cleavage or a firm ass to spark desire.
All you need is to anticipate getting naked with her to get an erection. Most women need to have an emotional connection
with a partner before wanting to have sex. That takes time and the right set of preliminary circumstances. What’s more,
while a man immediately knows he has an erection, most women aren’t aware of initial arousal—increased bloodflow
and lubrication—until much later. Rosemary Basson, MD, a clinical professor of psychiatry at the University of British
Columbia, found that for many women, desire for sex doesn’t kick in until much later and is entwined with feelings of
emotional closeness that make them receptive to being aroused.
What Does All This Mean to the Man with PE?
Well, it should reinforce the idea that superlong and miraculous performance in bed isn’t the most important aspect of sex
for most women. Many gynecologists we have interviewed have told us they rarely hear complaints from women about their
partners’ small sizes or quick triggers, but they constantly are asked about ways to get men to be more emotionally present.
For a healthy, satisfying sex life with your partner, you need to focus on the emotional connection, not the genital
one. Stop comparing your sex to the marathon moaning sessions you see in porn flicks, or in the movies for that matter.
Forget performance and theatrics. Sex standing up or on a beach or the hood of a car or in the shower is never as good (or
comfortable) as it looks in the movies. And she’ll be the first one to tell you that.
There are dozens of ways that you can make her feel beautiful, loved, sexy, and respected and share incredibly
satisfying sex even if you can never do it like you, and countless other men, think you should be able to.
We hope we’ve convinced you to pay less mind to the length of time between insertion and orgasm and more to
the emotional strength of your relationship. That’ll make it easier to take the all-important step of talking with your partner
about your PE.
Can Prescription Drugs Help PE?
For the past 10 years, physicians have been prescribing a certain type of antidepressant for the off-label treatment
(use for an unapproved purpose) of premature ejaculation. Fluoxetine (Prozac) and paroxetine (Paxil), both selective
serotonin reuptake inhibitors (SSRIs), are two of the most popular choices. This isn’t because PE is making men
depressed (although it probably is, in many cases); it’s because delayed ejaculation can be one of the side effects of
SSRI use.
SSRIs boost the brain level of serotonin, a neurotransmitter that affects such basic body functions as
appetite, sleep, and sexual desire. When there isn’t enough serotonin in a small area of your brain stem known
as the (get ready now) nucleus paragigantocellularis, your time to ejaculation speeds up. In one review study,
fluoxetine was shown to increase men’s time threefold. Paroxetine increased their time eightfold, although that drug
comes with a higher risk of side effects, such as drowsiness and nausea.
An SSRI could be an effective part of a multitiered strategy to help men with PE gain control over their
ejaculations. Here’s a list of drugs that have been prescribed for this purpose. The first drug, dapoxetine (Priligy),
leaves the body quickly, so it is thought to hold potential for on-demand use against PE. However, it is not available
in the United States.
Drugs Prescribed for PE
DRUG
FREQUENCY
DOSE
(MG)
Dapoxetine
(Priligy)
As needed
30–60
Clomipramine Daily dose
As needed
(Anafranil)
Sertraline
Daily dose
(Zoloft)
Fluoxetine
(Prozac)
Citalopram
(Celexa)
Paroxetine
(Paxil)
12.5–50
EJACULATION
DELAY TIME
(MINUTES)
2.5–3
50–200
6
4
5
Daily dose
20–40
5
Daily dose
20–40
2
Daily dose for
30 days, then as
needed
Daily dose
As needed
10–40
11.6
SIDE
EFFECTS
STATUS
Nausea,
diarrhea,
headache,
dizziness
Fatigue,
dry mouth,
yawning,
nausea,
diarrhea,
perspiration,
decreased
sexual desire,
erectile
dysfunction
Approved for PE in
some countries
Prescribed off-label
8
1.4
You’ve also learned lots of useful tips and lessons to help you build greater confidence in bed. Having arousal
awareness, doing masturbation training, using the start-stop technique, and getting a prescription for an SSRI to help take the
edge off your anxiety and your hair trigger are just a few of them. Now’s the time to put it all together, bringing what you’ve
learned about your body and her mind into practice in the bedroom.
CHAPTER SEVEN
A LOW, SLOW BURN
The foreplay formula that will extend your pleasure and hers
You’ve heard the saying “Sex starts between the ears”? We’d like to add “outside the bedroom” and “in the morning” to that
phrase. An amazing night of sex begins many hours beforehand with seduction and planning. That’s especially true for the
man who’s trying to manage his PE.
Remember, a woman needs to two things to really want you badly: an emotional connection (feeling loved, adored,
appreciated) and a relaxed mood. Tension, job stress, dirty dishes in the sink, kids threatening to burst through the door,
worries about her appearance—all of these things distract her from thoughts of playing naughty nurse and make it very
difficult for her to get aroused, let alone have an orgasm. Eliminate stress and ensure that sex starts between her ears and you
are on your way to warming her up more quickly and managing your own anxiety more effectively.
Plan, Man
Think about the last time you had to speak in public and it went really well. Maybe your boss asked you to address the
department or you presented something at an industry conference or a local Rotary Club meeting. It was well received
because you appeared confident. You felt confident because you were well prepared. You had a goal for the talk and an
outline of key points to keep you on track. And you had practiced it a couple of times in front of the mirror. Well, at the risk
of making sex seem mechanical, we suggest that you approach the bedroom in a similar way. Spontaneity can be great for
sex, but not so much for the guy dealing with performance anxiety and PE.
Schedule sex. As unsexy as it sounds, planning to have sex is a savior for married couples with small kids. But it also works
great for busy singles with too much to do and no time to do it. When you plan to make time for sex, you eliminate the
anxiety of the unknown—will we or won’t we?—and potential rejection. Plus, the anticipation of the rendezvous is…hot.
Make it comfy and give yourself time. Again, stress is a sex killer for her and a quicker picker-upper for you. So do
whatever you can to make the bedroom an oasis of calm, quiet, and, comfort where, ideally, you’ll have at least an hour
without distractions. If there are others in the house, get them out of the house or at least lock the door so there’s no anxiety
about being caught doing reverse cowgirl at a full gallop.
Start foreplay over oatmeal. Her androgen levels are high in the morning and low in the evening, which means her body is
more receptive to sexual signals in the a.m. However, at that time of day, she’s also stressing about getting to work on time.
So it’s up to you to help her start thinking about you during her day so she’ll feel so emotionally connected to you she’ll
want to rip your clothes off that night. Pour her coffee. Clean up the breakfast dishes. Tell her how hot she looks in that
blouse. Give her a long hug and a kiss. This is the beginning of all-day foreplay.
Call her after lunch. Remember that men respond to visual triggers, women to internal ones—a thought or personal
connection that she finds romantic. When you call her during the day to check in, you are relationship building. You may not
need that connection to feel good at the end of the day. But she does.
Apply a 20-second hug. When you come home from work, you’re stressed. She’s stressed. On-the-job pressures produce
cortisol, the stress hormone, and it follows you home. What you both need is oxytocin—the so-called cuddle hormone that
counteracts stress and encourages bonding. Oxytocin production is stimulated after only 20 seconds of hugging. It’s the
perfect way to extend your all-day foreplay and transition into all-night sex play.
Use your tongue. Want to know the secret to turning a woman on? Talk.
Some of the best foreplay is verbal. A perfect transition to the bedroom is sitting on the sofa, turning off the TV,
and talking. Quiet talk continues the unwinding process and helps you connect. Talk about the kids, the dog, upcoming
events, anything that reinforces the notion of you as a team. Recent relationship studies at the University of Rochester show
a correlation between a man’s nonsexual responsiveness and increased sexual fantasizing and greater interest in sex in his
partner. “One of the best ways a man can make his partner feel special and desired is to pay attention and really listen,” says
Gurit Birnbaum, PhD, from the Interdisciplinary Center Herzliya in Israel. “Sexual desire thrives on this rising intimacy.”
Hit the lights. One of the biggest reasons women have trouble relaxing during sex is negative body image. They worry
about how they look naked. Keep the lights low in the bedroom to keep her body out of a spotlight. A candle is perfect. The
low light may also dim your visual stimulation, helping you to maintain better control.
Slow everything down. A lot of guys get into the routine of kiss-fondle-insert-finished. You want to extend the foreplay
by slowing all of your moves way down. Start with at least 15 minutes of kissing and caressing before moving downward.
“Lots of kissing reassures her that you’re not simply out for sex,” says Yvonne K. Fulbright, PhD, the author of Touch Me
There! Trace her lips with your tongue, and alternate soft kisses with gentle sucking on her lips. Taking your time with
kissing cements that emotional connection you’ve been working on all day. The unhurried approach also allows you time to
acclimate to your naked bodies touching and reduce your anxiety and sensitivity.
While you’re kissing, encourage sexual talk. Ask her about her fantasies and to elaborate on them. Fantasy, a cousin
of dreaming, helps her brain deactivate. It may be necessary for her to close her eyes and let her thoughts wander. Asking her
to fantasize while you touch her gets her hot and puts you in control of your level of stimulation. Many women take about 8
minutes to become aroused before they want clitoral stimulation, “so double that and you should have her at the brink,” says
Darcy Luadzers, PhD, a sex therapist and author of The Ten Minute Sexual Solution. Caress her breasts, lick her nipples.
Take it slow. Trace your hand along the outsides of her hips, slowly, teasingly. Then slowly work your way between her legs.
Extend Intercourse with Outercourse
The average man thinks foreplay should take about 15 minutes, but in reality it averages less than 12. Most women would
like it to go on for 18 minutes, according to a study at the University of New Brunswick in Canada. Remember, most women
can’t reach orgasm with intercourse alone; they need manual and/or oral stimulation. That’s why the male obsession with
going all night may be kind of misplaced. “I don’t come from sex anyway!” says Jennifer, a magazine editor in New York
City.
In fact, women report more orgasms when a vibrator is part of sexual play. So, to be a truly amazing lover, a man
must understand a woman’s need for foreplay and clitoral stimulation. This presents a great opportunity for the man who
is struggling with PE. He and his partner can have mind-blowing outercourse even while he’s training himself to lengthen
his control during intercourse. Consider: A woman’s vulva has more orgasm-triggering nerve endings than her vagina does.
Rather than hunt for the elusive G-spot, the famed pleasure zone hidden deep inside of her, focus on the easy-to-reach glans
clitoris on the outside. The visible nub of her clit boasts 8,000 nerve endings, twice as many as your penis!
By using a vibrator (see “Fire Up the Fukuoku”) or skillful hands and tongue during foreplay, you can get her off
first, which lessens the psychological pressure on you to perform. And because a woman’s orgasm threshold drops after
she has had her first one, it’s often easier to bring her to climax with penetration after she’s already had one O through
outercourse. With some deft dexterity, you can give her moan-inducing multiple orgasms and time your insertion to climax
simultaneously with one of her orgasms even if you can’t hold off very long while thrusting. Top it off with some romantic
postcoital cuddling, and you will have fulfilled almost every woman’s deepest desires.
Tease more than touch. Lie next to her, lightly bracing the heel of one hand just above her clitoris. Now run your ring
and middle fingers along her outer lips. Do this ever so gently, grazing the skin lightly, then adding pressure as her tension
builds. If she is too sensitive for direct clitoral stimulation—most women are—cup the area around her clitoris with your
palm to add indirect stimulation, says Debby Herbenick, PhD, a sexual-health researcher and Men’s Health Sex Professor.
“As she becomes aroused, brace your hand on her pubic mound—the fleshy area that covers her pubic bone—and tease the
clitoris with the middles and tips of your fingers as you move your entire hand.” For variety, pinch her labia gently. Then
insert two fingers, pressing them up against the front wall of her vagina to simultaneously stimulate her clitoris and G-spot.
She’ll press and grind her clit into your palm. This combo stimulates her entire vulva.
Do not enter. Not yet, at least. Some men who get so excited they come before penetration may benefit from a technique
called VENIS—very erotic non-insertive sex—that removes the pressure felt with goal-oriented sex in order to build more
romantic intimacy. VENIS is sexual contact without penetration. But unlike the dry humping you did in high school, it’s
more sensually sophisticated. Massaging her with warm oils, bathing together, licking whipped cream off of each other’s
bodies, cuddling in bed, and masturbating together all qualify as VENIS moves, and they can help a man build ejaculatory
control by relaxing and habituating him to erotic touch.
Another form of VENIS that we recommend for last-longer training is femoral intercourse, in which you move
your penis back and forth between her closed thighs without penetration. Since the top of your penis is less sensitive than
underneath, you can stimulate yourself (and her) while staying in control. You can do this in a number of sex positions, but
spooning (your front to her back) and side-by-side (facing one another) are among the easiest because you can keep your
penis parallel to her vulva and deftly use your hand to control the action.
Touch pointers: The facing side-by-side position allows you to look into her eyes, kiss her, and touch her breasts, all
of which will steal your concentration away from your throbbing penis.
Move your body tightly against hers so the base of your penis or pubic bone presses against her vulva. Then use your
hand to press your penis between the folds of her labia like a hotdog in a bun while simultaneously stimulating her clitoris.
This is a good position to help her achieve her optimal phase of physical arousal, called uterine tenting. Allow her to slide
and rub against you—she’ll establish the ideal rhythm—while you use your hands and mouth elsewhere.
In the facing position, also try lifting her top leg over yours. Using your hand, rub the head of your penis over her
vulva and clitoris. Try inserting it shallowly and briefly in a tease that she’ll love and will keep you in control. Anytime you
feel yourself nearing that 6, 7, 8 level (remember? From your masturbation training?) and the point of no return, squeeze the
head of your penis to temper the rising stimulation.
Become a cunnilingus virtuoso. “Making love with one’s penis is like trying to write calligraphy with a thick Magic
Marker,” says sexologist Kerner. “The tongue is mightier than the sword.” Kerner’s book She Comes First: The Thinking
Man’s Guide to Pleasuring a Woman is a handbook of amazing tips and techniques that every heterosexual man should read.
Two of Kerner’s basic yet most brilliant tips: (1) Reassure your partner that going down on her is a real turn-on for you, and
(2) consider the virtue of a firm, flat tongue held still that she can move against to climax.
Touch pointers: Go slow with oral sex. Fifty-two percent of women in a Men’s Health poll said they want you to
spend at least 15 minutes south of the border. Build tension with teasing. Start with light kisses and licks on her inner thighs
before moving to her inner and outer lips. Barely touch her clitoris. Stop. Let her breathe while you kiss her inner thighs.
Repeat. Work your tongue inside with firm, broad strokes. Her hips will demonstrate the rhythm she likes. When she’s close
to climaxing, you’ll notice a subtle deepening in the color of her labia, caused by increased bloodflow. If you rest your hand
on her belly you may feel muscular contractions that precede her orgasm. If your tongue gets tired during oral sex, let her
do most of the work, as Kerner suggests, by allowing her to press and grind against your firm but resting tongue. Then go
for long, ice cream licks starting from her perineum and covering her entire inner labia and ending at the head of her clitoris.
Keep a slow pace and consistent rhythm. When you sense her going bonkers, speed up with quick vertical and horizontal
tongue strokes directly on her clitoris.
Breathe deep, go slow. Just as you’ve acclimated to some pretty hot and heavy outercourse action while staving off
ejaculation, you can learn to do the same with your penis inside of her. The trick is to go slow enough to manage your
sensitivity. Spending some minutes there without moving can acclimate your penis to the warm, wet environment and
dissipate the heightened feeling that can trigger ejaculation. Of course, it helps to let her in on what you’re up to lest she
wonder if you’ve fallen asleep.
“Men need encouragement in the counterintuitive act of penetration and lying still,” says Mike Perring, MD, the
medical director of Optimal Health of Harley Street in London. He suggests that you share your breathing pattern and
connect emotionally with your partner—talk about how sexy she looks and how good you feel inside her—but have
absolutely minimal movement. This isn’t simply a recommendation for men struggling with premature ejaculation, either,
but rather an exercise with a much wider usefulness. “Men are prone to get in there and thrust away,” Dr. Perring says.
Slowing down “allows them to explore what their sexuality is for themselves. Too often, we’re ignorant about our own
sensations—how does it feel to be touched there, or there, or there?” Ironically, developing hyperawareness is the road to
greater control.
As you begin to move inside her, focus on breathing deeply and relaxing those PC muscles you’ve been training.
(Remember, to relax the muscles at the base of the penis that trigger ejaculation, bear down as if you’re trying to have a
bowel movement.) Or, if you sense you are nearing your limit, try the start-stop method or pull out and give your penis a
squeeze to force out some of the blood and stifle ejaculation and regain control. Take a break for a few minutes to kiss and
concentrate on other parts of her body. Massage her clitoris with your fingers or go back to oral sex. “If you’re smooth she’ll
have no idea you’re just trying to regulate your ejaculation,” says Brian Mustanski, PhD, an assistant professor of psychiatry
at the University of Illinois at Chicago. “But all you have to do is let your system settle from its excited point.” Pulling back
when she’s near climax can benefit her, too, by actually enhancing her orgasm—the suspense can raise her psychological
arousal level.
Build and plateau. You can use start-stop and squeeze techniques to drive her completely crazy. In a recent National Survey
of Sexual Health and Behavior, researchers found that sexual variety—specifically, engaging in several sex acts—was linked
with women’s reports of orgasms. Use the regain-your-composure breaks to change positions or vary the action with another
type of stimulation.
“The majority of women would rather have intense stimulation for a shorter period of time than continuous and
unending sensation,” says certified sex educator Lou Paget, author of How to Be a Great Lover. While a man’s arousal is
like a pyramid, continuously growing until climax, “a woman’s arousal is like a staircase. She needs to build, plateau, build,
plateau. This means moving out of the genital-sex-only way of thinking and into sex-play mode. Use lots of general sex
play—kissing, squeezing, oral sex, and so on. And do this before, during, after, or even in lieu of penetration. The great
news here is that you can still have sex for hours, as long as you think of sex as any time spent rolling around naked together
rather than just intercourse.
Be a gentleman. Again, one of the most effective strategies for lasting sex is letting your lady come first. By treating her to
an orgasm before you have yours, you relieve some of the anxiety and pressure to perform that fuels rapid ejaculation. And
her ability to have multiple orgasms presents an added opportunity for you: Her subsequent Os typically will come quicker
and easier, affording even guys with short fuses the real possibility of satisfying their partners through intercourse.
The key here is recognizing when she is on the verge of climaxing. Watch for signs that she’s close, like increasing
gasps and moans, a deepening in the color of her labia caused by increased bloodflow, the rhythm of her hips, and the
muscular contractions that precede her orgasm. Too much to think about? You’re right. These signs can be challenging to
detect, so make it easier on yourself: Ask her. Simply ask her to tell you when she is very close and suggest that she quickly
move on top of you at that time. As we mentioned before, female superior positions, like the cowgirl and reverse cowgirl,
give men greater ejaculatory control. You can relax, lie still without thrusting, and allow her to set the rubbing rhythm and
ideal pressure on her clitoris that it takes to achieve her orgasm. And even if you do come before she climaxes, ejaculation
doesn’t signal the end of sexual activity or even intercourse. She can still get there by grinding her clit on your pubic bone
with you inside of her. Even if you lose your erection, you can use your fingers to coax her over the edge. (Remember that
consistency of rhythm and pressure are crucial. Think waves on the beach as you rub.) Maybe your partner will gently push
your hand away and say she just wants to cuddle, but it’s more likely that she’ll writhe against your fingers in ecstasy.
Cuddling, which is important too, can come later. But don’t forget it. Fifty-six percent of women say they want about
20 minutes of postcoital closeness. Hey, and that may be just enough time for you to be ready for another round.
CHAPTER EIGHT
BIGGER, BOLDER, BETTER
Exercises, pills, even surgery—they all promise to make your penis bigger. But do they work? Here’s the truth.
“How can I make my penis bigger?”
That question, or a variant of it, is one of the most common inquiries readers make to the most popular departments
at Men’s Health magazine: Ask Men’s Health, The Girl Next Door, and The Sex Professor. Which means it’s on the minds of
a lot of men out there.
The obsession with penis size isn’t new. In fact, it goes back centuries, if not millennia. In The Strangest Human Sex,
Ceremonies and Customs, the authors tell of prehistoric cave dwellers who gave symbolic values of strength and power to
penis size and of Indian Sadhus using weights to lengthen their penises. Same thing in Uganda, says Don Voorhees in his
highly entertaining book of sex trivia, Quickies. Weights are tied to the ends of boys’ penises at puberty, and the weight is
gradually increased. “A teenager may eventually end up with a 20-pound stone disc swinging from the end of his member!”
Apparently, it’s very effective—a boy’s penis can be stretched to up to 18 inches. However, as Voorhees points out, these
extended penises may be long, but they’re thin, making it difficult to do even simple things like sit down.
It gets worse. According to British author Graham Masterton in his book Up All Night, in 16th-century Brazil, the
Topinama Indians found a way to enlarge their erections to immense sizes by encouraging poisonous snakes to bite them.
Apparently, it worked—terrible pain for 6 months, then monstrous penises. But, as Masterton points out: “Like the first man
to eat an oyster, it makes you wonder who was mad enough to try it first.”
Animal researchers study penis length as well. The oldest known species with a penis is a hard-shelled sea creature
called Colymbosathon ecplecticos. That’s Greek for “amazing swimmer with large penis” (which is also what some women
call beach lifeguards). But take heart, human men, for your human penises are larger than would be expected for a species of
our size. In comparison, a silverback gorilla weighing up to 400 pounds has an erect penis that’s just 2 inches long.
All of that may be both interesting and entertaining, but there’s a simple fact that’s getting lost in all the fun: A man’s
penis size can have a direct effect on his mental health, self-esteem, and romantic relationships.
It doesn’t—and shouldn’t—have to be this way. Size does not matter as much as you think it does. This chapter
will tell you everything you need to know about penis size, including research showing that most men who think they’re
“undersized” are actually average or above average below the belt. We’ll also debunk the myths surrounding penis size,
show you the truth about all the penile lengthening procedures and products you’ve heard about, and, finally, give you all
the info and advice you need on how to lengthen your penis naturally and safely, as well as how to make sure your partner is
satisfied no matter what you’re packing in your pants.
Remember what Yoda said, men: “Size matters not.”
Why Our Eyes Always Look at Size
“Anxiety or insecurity about penis size is extremely common in men,” says Stephen Snyder, MD, a sex therapist and
associate clinical professor of psychiatry at Mount Sinai School of Medicine in New York City. The reasons are manifold,
but the most common ones tend to be:
Women. It’s possible a man had a negative sexual experience with a woman and he (or she) equated it to his size. Then
again, his size may be perfectly adequate, but in a bad breakup or argument, for example, a woman insulted his size. And it
stuck.
Other men. In a recent study of men who complained of having small penises, nearly two-thirds of them said the problem
started in childhood when they compared their penises to their friends’. This may be why researchers have found that the
average man thinks he’s below average. When Peter A. Lee, MD, conducted penis research at the University of Pittsburgh,
he found that “men were good at appraising their overall physique,” he says, “but when it came to relative penis size, as a
group they tended to underestimate.” Twenty-six percent of respondents in Dr. Lee’s study gauged their own penis sizes as
“below average,” while a mere 5 percent ticked the “above average” box.
Why? “It’s difficult to accurately assess penis size,” says Dr. Lee. The damn thing is always growing bigger and
smaller, and your point of view can be misleading. “If you’re in a changing room with other men, theirs may look bigger
because you’re seeing them in profile. You look down at your own.” In every sense of the phrase.
Popular culture. Debby Herbenick, PhD, a sexuality researcher at Indiana University and a Men’s Health Sex Professor,
says penile worries arise from “cultural myths and stereotypes about penis size that stem from television, movies, jokes told
among friends, and advertising messages from companies that present false information about penis size in order to sell
products that probably don’t even work.”
Indeed, references to penis size abound in movies and TV shows. The Sex and the City girls had frank talks about
what was big and too big, the HBO show Hung is about a massively endowed teacher who moonlights as a gigolo, and
comedian Sarah Silverman mused about what every woman really wants in There’s Something About Mary: “[A] deaf-mute
with a 3-pound cock and a trust fund.”
Most guys have enough of a sense of humor to laugh at that. But when you hear a consistent message over a period
of years, it starts to sink in.
Pornography. This may be the biggest issue (pun intended). Porn has become more and more mainstream in society
because of pop culture and the Internet. Free video clips are a mouse click away, and any man who watches even
semiregularly sees nothing but guys with gigantic penises having sex with women who moan, talk dirty, and in effect
worship what’s between the actor’s legs. “The majority of men compare themselves to something they see in adult material,”
says Lou Paget, PhD, author of The Great Lover Playbook. “They haven’t seen another man’s penis up close. But women
see them all the time. And we see a whole range of sizes,” she says.
A porn actor’s penis isn’t what most women want anyway. “When women watch male porn stars humping away
like lobotomized underwear models,” says Nicole Beland, a former Men’s Health Girl Next Door, “it’s almost always with
a cringing, confused expression. Getting pummeled with a giant penis is painful, not fun. The majority of women don’t
consider bouncing up and down on a Poland Spring bottle to constitute great sex.”
And yet, there are a lot of men out there who are still insecure. When those insecurities persist, they get classified
as a condition called penile dysmorphic disorder—PDD for short—the persistent and distressing belief that you’re
packing unusually small equipment even though your actual size is average or above average. In a recent study published
in the British Journal of Urology International, researchers found that 63 percent of men complained of having inferior
hardware—but none of them were smaller than normal. Some experts call this small penis syndrome.
Crazy, right? Well, that’s why it’s associated with a diagnosable psychiatric disorder, dysmorphophobia, a fixation
on an imaginary flaw in physical appearance. It’s hard to tell how many guys suffer from the disorder, partly because, as Dr.
Snyder indicates, men suffering from it are convinced they have a physical abnormality, so they’re not talking. Likewise,
they’re far more likely to consult a surgeon than a mental health professional (more on that in a minute).
That mind-set can be difficult to break. “Some people have an innate tendency for obsessive thinking,” Dr. Snyder
says. That causes them to do things that only make the problem worse—like compulsively measuring erections or avoiding
dates because of the potential for humiliation. Ironically, that leads to even more problems in bed—they spend so much time
fixating on themselves that they eventually neglect their partners. “The whole thing spirals out of control until ultimately
he’s online studying penis enlargement techniques.”
So…just how big is an “average” penis? Some stats:
• Average penis length and diameter (flaccid) = 3.5 x 1.25 inches
• Average penis length and diameter (erect) = 5.1 x 1.6 inches
• Average percent increase in volume, flaccid to erect = 300
Fire Up the Fukuoku
Sounds hot, huh? No, it’s not a new barbecue grill from Japan. The Fukuoku 9000 is one of the coolest vibrators
around. This tiny, nubby-surfaced vibrator fits on the tip of your finger—so it actually turns your finger into a vibrator
of its own. For guys with PE, using a vibrator or another sex toy for foreplay or even intercourse is a great way to
extend sex and guarantee her satisfaction. Several surveys have shown that women who use vibrators report higher
levels of desire, arousal, lubrication, and orgasm. And men who use vibrators with their partners during sex also
report better sexual functioning. The Fukuoku 9000 is available at www.babeland.com. Other top vibrator models
are the Iconic Ring, a disposable vibrating cock ring—for hands-free vibration—from www.jimmyjane.com; the Nea,
a petite but powerful curved model with a battery that lasts for an enviable 7 hours from www.lelo.com; the wildly
popular line of Rabbits from www.therabbitvibrator.com; and Doc Johnson’s Lucid Dream No. 14, a full-size vibrator
made of flexible jelly rubber, from www.drugstore.com.
The fact is, all this self-doubt is largely unfounded—or at least as it pertains to a man’s ability to keep his lady happy.
The average vagina is 3 to 5 inches long, and only the first third—that’s 1 inch or so—has a large concentration of nerve
endings. You do have at least an inch, right? “The average penis is perfectly suited to the average vagina,” says British sex
therapist Phillip Hodson, author of How Perfect Is Your Mate? “It might not be perfectly suited to appear in pornography,
but that’s a different story entirely.”
Want the Truth? Ask the Ladies
So, does penis size matter to women? To the majority of them, no. One study showed that 85 percent of women reported
they were happy with their partners’ sizes. And the “size doesn’t matter” argument has been posed by sex experts for
decades. Of the many debts we owe to sex researcher Dr. Alfred Kinsey, one stands out. He was the first expert to publicly
say that penis size doesn’t matter—in 1953.
And, when you talk to the experts who really count—women, in other words—you hear something very similar.
“Every guy I’ve ever, um, known has confessed that he didn’t think his penis size was anything to write home about,” says
Beland. “But they were all perfectly well hung.”
Sometimes women are right when they say men don’t listen.
So the old cliché holds true (even if some men refuse to believe it): It’s not how big it is, but what you do with it. In
a recent survey, only 7 percent of sexually satisfied women said penis size is critical to their pleasure. The other 93 percent
said they could be satisfied in other ways. “Passion is what keeps women coming back for more,” says Yvonne K. Fulbright,
PhD, the author of Touch Me There! Survey participants agreed: They were 10 times as likely to rank both passion and
generosity as more important than penis size.
See it from her perspective. Guy #1 has an armadillo in his pants and zero oral or social skills. Guy #2 has a perfectly
respectable member, can tie a cherry stem in a knot without using his hands, and offered to dance with her aged and
toothless Aunt Millie at her cousin’s wedding without prompting. Ask the average woman to choose, and she doesn’t even
have to think about it (unlike the way you might have to think before choosing between your beloved and a pair of tripleDs). Guy #2 is getting lucky tonight—let’s just hope he can banish all thoughts of Aunt Millie before the games begin.
The biggest problem with large penises, women say, is that they’re often attached to even bigger dicks. “There’s
nothing worse than a guy who thinks he has a huge penis and is therefore God’s gift to the ladies,” Beland says. “That kind
of guy thinks that getting an erection is pretty much all the effort he has to put into sex. The chances that the women he
sleeps with are having orgasms? Slim to none.”
That’s the key, says Kerner: Worry more about her pleasure than your size. “Usually when women complain about
a small penis, it’s also that they’re not having orgasms. If they’re orgasming, it’ll matter a hell of a lot less what size your
penis is.”
That’s why it’s so necessary to remember the most important penis fact of all time: Most women don’t experience
orgasm through penetrative sex alone. Your length, strength, and lasting power are important things, sure, but not the
most important things. In fact, a recent Kinsey Institute study found that the likelihood that a woman will have an orgasm
increases with each additional stimulus incorporated into the experience.
Does that mean you should constantly switch positions (e.g., girl on top, missionary, doggy style, etc.)? Not
necessarily. Rather, it means you should also focus on oral sex, manual sex, mutual masturbation, and so on. (You’ll notice,
perhaps, that a penis isn’t even necessary for some of those acts.) If nothing else, remember this mantra: The more you do in
bed, the more likely she is to climax.
Oh, and one more thing, says Herbenick. Listen to what your partner says about your penis. “Trust and believe her if
she says, ‘Honey, you’re fine’ or ‘I like you just how you are,’ rather than second-guess yourself.”
The Truth About Penile-Lengthening Gadgets,
Supplements, and Surgery
Gentlemen, we get the same spam you do, endless promises of pills, doohickeys, and miracle-grow solutions for your penis.
The obvious question: Do they work? We have the answers. Here’s what the experts say and the research shows.
Gadgets
Vacuum devices. You might be more familiar with the term “penis pump,” as seen to great effect in the first Austin Powers
movie. Penis pumps were originally developed to treat erectile dysfunction because they help increase bloodflow into the
erectile tissue of the penis. Pass on this one, Austin. Men saw only a 0.1-inch increase in penis size after 6 months of regular
pumping.
Botulinum toxin, aka Botox. This one might actually work. A recent study found that Botox may temporarily improve
flaccid length by decreasing penile contractions. See, the dartos muscle—an involuntary muscle in the scrotum that can
affect the penis’s appearance—sometimes contracts in cold environments or during stress, making the penis look smaller
(shrinkage!). Injecting this muscle with Botox prevents these penis-shortening contractions. The question is, How important
is flaccid length to you?
Penile extenders. A penile extender is a splintlike device made of a plastic ring and two metal rods that puts force on the
penis. (Not just for masochists anymore!) The penis is inserted into the ring and the head is strapped with a silicon band,
according to a review study by Paolo Gontero, MD, and colleagues. Force is applied to the penis at an increasing rate,
starting at 1.3 pounds and ending at 3.3 pounds, which supposedly stimulates the growth of the tissues.
One study reported an average increase of 0.7 inches when men used an extender for at least 6 hours a day for 4
months. Yup, 6 hours a day. And another study found a 0.9-inch increase after using the device for 4 hours a day, every day,
for 6 months. The effect even had some longevity, as it remained 6 months later.
So, although penile extenders do seem to have the biggest effect, we’re not so sure wearing a splint around the
penis—for at least 720 hours—is really worth it.
Pills and Supplements
Avoid ’em all, no matter how convincing the advertisements may be. The bottom line, says Herbenick: “I know of no
evidence to suggest that there are any herbs or pills that can safely or effectively increase the length or girth of a man’s
penis.”
Another reason to stay away? You have no idea what you’re really buying. You may notice a sentence on the label
or in the advertising fine print saying something such as “These statements have not been evaluated by the Food and Drug
Administration (FDA).” Indeed, manufacturers don’t have to provide evidence of safety or effectiveness to the FDA before
putting dietary supplements on the market.
Exercises
Some men try to take matters into their own hands with a technique called jelqing. These ancient Arab exercises use a
hand-over-hand motion to push blood from the base to the head of your penis. Although this technique appears to be safer
than other methods, it can lead to scar formation, pain, and disfigurement. There are no scientific studies indicating that this
technique is effective at increasing penis size.
Surgical Techniques
Some men—more than 15,000 in the United States, although that’s a very rough estimate since no official numbers are
available—have opted for surgical procedures to lengthen and widen the penis. Two common surgical techniques are
injecting fat to increase girth and severing the suspensory ligament to increase length. Here’s what they entail.
Fat injections. It’s a liposuction procedure: Fat is sucked out of some other part of your body (usually the abdomen) and
injected into the shaft of the penis. The procedure does seem to work, though the penis can appear lumpy (from fat clumps)
and the fat will eventually be reabsorbed by the body.
Ligament surgery. The most widely used surgical procedure to lengthen the penis involves severing the suspensory
ligament that attaches the penis to the pubic bone and moving skin from the abdomen to the penile shaft. When this ligament
is cut, the penis appears longer because more of it hangs down. But cutting the suspensory ligament can cause an erect penis
to be unstable. The surgery is sometimes combined with other procedures, such as removing excess fat over the pubic bone.
A number of urologists do a brisk business in correcting bad surgeries. Some, like Gary Rheinschild, MD, a urologist
in Anaheim, California, claim that if penis enlargement “is done properly, the results are good. Unfortunately, most of the
time, it’s not done properly.”
Why? Because the procedure isn’t taught in medical schools, is not regulated, and is not safe. When things do
go awry—as they often do—men are often too embarrassed to tell anyone. For these reasons and more, the American
Urological Association and the American Society of Plastic Surgeons (ASPS) do not endorse penis-lengthening procedures.
The procedure is not only often performed improperly, but also performed on men who simply don’t need it. A study
in the Journal of Urology concluded that lengthening procedures should be advised only for men whose penises are 1.56
inches or less when flaccid and not more than 2.9 inches erect.
“I have men who come back time and time again wanting this surgery, and each time I reassure them that they fall
well within the normal range, and in many cases above the normal range,” says Laurence Levine, MD, director of the Male
Sexual Function and Fertility Program at Rush University Medical Center in Chicago. “I routinely recommend they see
a sex therapist instead.” He also points out that the surgery, even when properly performed, may not achieve the desired
results. “In many cases, men see less than an inch added after the surgery, or even a decrease in length.”
“This surgery is something I’ve really come out against,” says Ronald Iverson, MD, a plastic surgeon in the San
Francisco area and former president of the ASPS. “There are no peer-reviewed articles that show that it’s an effective and
lasting procedure. Even in the best hands, it may not be a procedure that can be done safely and effectively,” he says. “If
Be Her Sex Machine
Lessons you can learn from her favorite sex toys
Strategic strokes, not size, spark her orgasm. If you really want to know what drives her wild, the
answer just might be hiding in her drawer.
Linger a little. Unlike porn actresses, most women first focus sex toys on their clitorises, penetrating only as
climax nears, says Lisa Lawless, PhD, founder of the National Association for the Advancement of Science and Art
in Sexuality.
What you can do: Your penis isn’t just for penetration. Use it to stroke her outer labia and clitoris during foreplay,
says Vivienne Cass, PhD, author of The Elusive Orgasm. Gyrating along these pleasure points while steadily
increasing the pressure will push her desire to the tipping point, so once you penetrate, you’ll deliver orgasminducing thrusts.
Pick the right position. G-spot stimulators target the spongy, sensitive area in the front wall of her vagina, about
2 inches from the opening. G-spot (as opposed to clitoral) orgasms come from strategic pressure, not size. “Those
huge man-made members aren’t what she’s hiding under the mattress,” says Lawless.
What you can do: To put pressure on this sensitive area with each thrust, enter her when she’s on her back, with
her knees resting on her chest.
Warm her up. With two vibrating petals shaped like a set of hare’s ears, a vibrator like the Rabbit rubs both sides of
her clitoris.
What you can do: Stimulate (gently) the clitoris from all sides. First, use your index and ring fingers to rub the
sides. After she warms up, simultaneously stroke the top of her clitoris with your middle finger, completing the
chorus that will send her over the edge.
Multitask. Dual-action sex toys massage her clitoris and G-spot in tandem so she’s flush with sensation in the two
areas that trigger an orgasm.
What you can do: Good things come in pairs. If you’re licking her clitoris, finger her G-spot. If she’s in the cowgirl
position, rub her clitoris. “At any given time, either the G-spot or the clitoris should receive attention,” says Dorian
Solot, coauthor of I Love Female Orgasm: An Extraordinary Orgasm Guide.
Change speeds. The classic multispeed vibrator lets her focus on her most nerve-rich erogenous spot, the clitoris,
as she slowly increases the intensity.
What you can do: A little change is good; too much can capsize an orgasm. Always start slow, with gentle, broad
strokes of your finger or tongue. Build toward a climax instead of rapidly changing techniques and intensity. Hum
while you lick and you’ll cause the same sensation as her pocket rocket.
you’re considering a penis enlargement for purely cosmetic reasons, you’d better think twice. In fact, let me be blunt: Don’t
do it.”
The Bottom Line on Any Penis-Lengthening Procedure, Gadget, or Pill
“Personally, if I had a penis I would probably want to wait a while before using stretching devices or getting surgery,”
says Herbenick. “After all, we know that many men who think their penis is too small actually have a totally normal- and
average- (or more) sized penis and maybe with time you’ll find a partner who worships it as-is or newfound self-confidence
that helps you feel more comfortable with your natural size. Plus, it’s your penis! So long-term safety data is definitely key
here, right?”
12 Safe, Natural Ways to Make Your Penis Bigger
and Your Sex Life Better
“It’s not how big it is, but what you do with it.”
Okay then, what should you do with it? Here’s what you can do to make it look bigger when it counts (and none of
these tips require straps, weights, pills, or scalpels).
Stop Smoking
Research shows that smoking can shorten your penis by as much as a centimeter. Why? Erections are all about good
bloodflow. “In addition to damaging blood vessels, smoking may cause damage to penile tissue itself, making it less elastic
and preventing it from stretching,” says Irwin Goldstein, MD, director of San Diego Sexual Medicine at Alvarado Hospital.
This transfers directly to the bedroom. In a study conducted at the University of Kentucky, researchers found that when
asked to rate their sex lives on a scale of 1 to 10, men who smoked averaged about a 5—a far cry from nonsmokers, who
rated theirs a 9. We have yet to hear a better reason to quit.
Masturbate More
Ejaculations don’t just feel good—they’re good for you, too. “I’ve seen men lose up to 2 inches off their erections because
they didn’t masturbate and have enough sex,” says Darius Paduch, MD, PhD, an assistant professor of urology at Cornell
University. “Your penis is basically a big muscle—it will atrophy if you don’t use it.” His Rx: Masturbate as often as you’d
like to be having sex. “What really matters is having an adequate outlet. Your penis doesn’t care whether that outlet is sex or
masturbation.”
Lose Weight
There’s a pad of fat in front of the pubic bone, just above the base of the penis. It’s there as a cushion for vigorous sex. But
as you grow older and gain weight, this pad thickens and starts to hide your penis. You lose a half inch for every 15 pounds
you gain. Unfortunately, crunches won’t tighten this pad. The only defense is to lose weight or stay lean.
Manscape
Trimming the pubic hair from around the base of the penis can make it look a bit longer. And it’s sexy to do together.
But if she’s down there with a pair of scissors, your friend might go into a defensive crouch, defeating the purpose of the
experiment.
Leave It Alone
If you’ve got a big night coming up, don’t masturbate for at least 2 or 3 days beforehand; this will cause your erection to be
at its largest and strongest, says Lou Paget, the author of 365 Days of Sensational Sex. When the fateful moment arrives,
squeeze a little as you slide off your shorts. By flexing the muscles of your lower abdomen, you’ll cause your penis to lift an
inch or two. You’ll also force blood into the head, making it momentarily swell even more than usual.
Avoid Shrinkage Conditions
For best results, avoid the following: cold weather, chilly baths or showers, exhaustion, nonsexual excitement, and illness.
All have been shown to shrink the average penis by as much as 2 inches.
Fire Up Her Brain
“Women’s pleasure and orgasm are much more a function of characteristics of sex such as intimacy, the psychological
experience, and technique than her partner’s penis size,” says Herbenick. That means she’ll be far more prone to orgasm
and being satisfied with sex when her mind is in the right place, i.e., feeling in love, dirty, naughty, excited, etc. Women,
obviously, are individual in their tastes, so think about your partner. What does she like in bed? What does she want? Don’t
know? It’s time to have a playful conversation over a bottle of wine.
and Her Body
The irony is that men spend so much time thinking about their own anatomy when they should be thinking about hers. “It’s
a man’s knowledge of female anatomy and ability to stimulate a woman in all the right ways that determines whether or not
we’re happy in bed,” Beland says. Embrace foreplay. “Twenty minutes of erotic foreplay with a guy who has a penis the size
of a Sharpie will be far hotter than 2 minutes of sloppy groping from a dude with a johnson the size of a flashlight.”
Perfect Your Lovemaking Pace and Movements
Make the most of what you have by using powerful, deep thrusts at a slow to medium pace. “It can be wonderfully intense,”
says Beland. “Pistonlike porno thrusting feels horrible. It can leave a girl dry, sore, and bored.” To vary the stimulation, add
side-to-side movement and up-and-down pelvic pressure against her clitoris when you’re all the way inside.
Try Hotter Positions
For the truly tiny or even those paranoid normal guys, Kerner recommends “pressing instead of thrusting in missionary
position, or trying woman-on-top,” both of which maximize clitoral stimulation. Beland suggests these positions: “Place her
legs on your shoulders during missionary position, enter her from behind when she’s on all fours, or, when she’s on top, put
a pillow under your butt to raise up your pelvis.”
Make Your Penis Feel Thicker (to Her)
British research has shown that women do indeed prefer a thick penis. The reason: “The greatest number of nerve endings
are in the lowest part of the vagina,” Beland says. “So when a thick penis pushes against the labia and lower vaginal walls, it
provides intense, pleasurable sensation. But men with thinner penises can provide a similar experience by penetrating in the
positions described above or moving their hips in a circular motion while thrusting.”
Be One Hell of a Guy
It’s true, gentlemen: Personality matters. Be smart, funny, interesting, considerate, and an all-around pleasure to be with,
and women will gravitate to you—and your bed. “Personality is more important than any physical aspect of a man’s body,”
Beland says. “Any woman who thinks otherwise isn’t worth dating.”
CHAPTER NINE
THE BETTER-SEX WORKOUT
A shape-up-fast plan for sexual stamina, greater pleasure—and awesome abs!
Sex is like any other physical activity that involves sweat and muscles—and grunting: Proper training is paramount for
primo performance. It takes strength, flexibility, and aerobic endurance to deliver a proper clitoral orgasm, and to do it
without dripping perspiration into her eyes. And think about all those tiny muscles that sexual intercourse activates that
rarely twitch during the normal course of the day. They need training, too!
A rigorous workout regimen designed specifically to add endurance, strength, and flexibility to key muscles and
joints involved in intercourse—including those that control orgasm—will help keep you lively between the sheets. And
that’s what we have for you below.
But there’s one more reason to stay fit for sex: Psychological factors are just as important. The process of getting
in shape can enhance a man’s self-image and confidence. When you are disciplined about working out regularly, you feel
good about yourself and that feeling overflows into your relationship with your partner. And researchers are finding that the
exercise itself is a turn-on. Studies show that men who work out regularly report increased libidos, more satisfying sex, and
less sexual dysfunction. Exercise increases the flow of endorphins and adrenaline, which play key roles in the chemistry of
arousal. Also, moderate exercise—weight lifting in particular—boosts the level of testosterone, the male hormone. And by
increasing the volume of blood and the capillary network throughout the body, regular aerobic exercise can increase a man’s
bloodflow. That means the pathways are clear and there’s plenty of blood to spare when the brain signals for an erection.
Here’s what you’ll get out of a workout like the one below.
Muscles for great sex. A solid core can lead to a great performance. A thrusting pelvis requires flexion and extension of
your lower-back muscles and hip flexors (which attach along your lumbar spine). The spinal erectors, which support your
spine—with help from the rectus abdominis and transverse abdominis—prevent your hip flexors and lower back from
tightening up. Depending on the position, secondary muscles come into play to push the body up, forward, or under. Or
wherever. Experiment.
A strong base. Conditioning your shoulders, triceps, and chest will make it easier to support your body weight, allowing
you to hold certain positions for as long as you need to—or as long as she needs you to.
Wilder positions through greater flexibility. The more limber you are, the more versatility you’ll be able to demonstrate in
bed. The moves in the workout below will stretch and lengthen your muscles.
Greater power! Occasional lower-back pain, spasms, and soreness after sex are often the result of muscular imbalances.
Training your smaller, sometimes-neglected muscles—and keeping them limber—means you’ll always be ready to go
another round.
More stamina. “Building a body for great sex has little to do with how much weight you can bench press,” says Jeff Bell,
CSCS, who designed our workout. “It’s about muscular stamina and rhythm, pushing and thrusting. It depends on how
skillfully your body can push and thrust. Using endurance exercises that mimic the motions involved in sex can prevent
weaker muscles from quitting too soon.”
More confidence. On top of all that, a lean, fit body tends to belong to a confident man. And we all know how much of a
role confidence plays in the last-longer-in-bed game.
Your Sexual Stamina Workout
It doesn’t take much to tap into your sexier muscles, but you need to train them for strength, stamina, and flexibility. In the
plan below, Bell includes moves that both strengthen and lengthen your muscles for the three most popular sex positions. To
get the best results from this routine, do 20 minutes of cardiovascular exercise at least two or three times a week in addition
to these moves.
The Workout
Exercising to improve your sexual performance requires functional movements that train your entire body to be more
flexible and resilient. The three stretches in this routine work your lower back, hip flexors, and glutes through their full
ranges of motion. The remaining five exercises develop areas that need stamina—your chest, shoulders, triceps, hamstrings,
quadriceps, and abs. That’s why you’ll be doing each exercise to failure instead of doing a specific number of repetitions.
Begin your 4-week program by choosing two of the four sections, then work your way up to doing all four sections in
one workout. In 4 weeks, you and your partner will notice a difference you’ll both be able to see and feel, no matter what
position you try. (You can also perform each stretch individually as needed—either immediately after sex or the morning
after—depending on which positions you used.)
WEEK 1
Create your routine by: Doing both moves in 2 of the sections
Sets of each exercise or stretch: 2
Your total workout should be: 8 sets
Speed of each rep and reps per set: As described
Rest between sets: 15 to 30 seconds
Do this workout: Twice a week
WEEK 2
Create your routine by: Doing both moves in 3 of the sections
Sets of each exercise or stretch: 2
Your total workout should be: 12 sets
Speed of each rep and reps per set: As described
Rest between sets: 15 to 30 seconds
Do this workout: Three times a week
WEEK 3
Create your routine by: Doing both moves in all 4 sections
Sets of each exercise or stretch: 2
Your total workout should be: 16 sets
Speed of each rep and reps per set: As described
Rest between sets: 15 to 30 seconds
Do this workout: Twice a week
WEEK 4
Create your routine by: Doing both moves in all 4 sections
Sets of each exercise or stretch: 2
Your total workout should be: 16 sets
Speed of each rep and reps per set: As described
Rest between sets: 15 to 30 seconds
Do this workout: Three times a week
SECTION 1: You on Top
Swiss-Ball Decline Pushup
WORKS: shoulders, chest, triceps, and abs
Kneel with a Swiss ball behind you and place your hands flat on the floor, shoulder-width apart. Place your shins on the ball
and get into the standard pushup position—arms straight, hands directly under your shoulders. Your back should be flat and
your abs drawn in. Tuck your chin and, leading with your chest, lower your body almost to the floor. Push yourself back up
and repeat until you can’t do any more.
Watch your form: Keep your head in line with your back and resist looking at the ball. Bending your neck in this position
can strain it, and you might lose your balance.
Lower-Back Lie-Down
STRETCHES: lower back
Lie flat on your back with your legs bent, feet flat on the floor, and arms at your sides. Draw your knees up to your chest and
gently grab your legs just behind the knees. Slowly pull both knees toward your chest as far as you comfortably can, keeping
your back flat on the floor at all times. Hold the stretch for 2 to 3 seconds, then slowly lower your legs. Repeat the stretch for
as many repetitions as you can.
Watch your form: Keep your tailbone and the back of your head on the floor. You’ll prevent your back from rounding,
which would lessen the effect of the stretch.
SECTION 2: Standing Positions
Hinge
WORKS: quadriceps, hip flexors
Kneel on a mat or soft carpet with your hands at your sides. Resist the urge to sit back and rest your weight on your heels.
Your back should be straight and your knees bent at 90-degree angles. Keeping your head and back in a straight line with
your thighs at all times, slowly lean back a few inches. Hold this position for 2 to 3 seconds, slowly return to the starting
position, and repeat as many times as you can.
Watch your form: Don’t bend at the waist or slouch forward—doing so will steal effort from the fronts of your thighs.
Standing Hip Thrust
STRETCHES: hip flexors
Stand with your feet together and your hands on your hips. Step forward with one foot so your feet are a couple of feet apart.
Keep your toes facing forward and your knees slightly bent. Gently push your pelvis forward until you feel a very mild
stretch in your hips. Although this move seems too subtle, don’t overdo it: The hip flexors are attached inside the legs in
such a way that it takes very little effort to stretch them. Hold the stretch for 5 seconds, then reverse leg positions and repeat
until you can’t do any more.
Watch your form: Try to keep the same knee angle throughout the stretch.
SECTION 3: You on the Bottom
Lying Gluteal Bridge
WORKS: butt, hamstrings, abs, pelvic muscles
Lie on your back with your knees bent and your feet flat on the floor. Place your arms at your sides, palms facing down.
Squeeze your glutes and slowly raise your butt off the floor until your body forms a straight line from your knees to your
shoulders. Hold this position for 1 to 2 seconds, then slowly lower yourself back down to the floor and repeat the move as
many times as you can.
Watch your form: Avoid looking at your waistline to check your posture. Keep your head flat on the floor and stare at the
ceiling instead.
Lying Crossover Stretch
STRETCHES: gluteal muscles
Lie on your back with your knees bent and your feet flat on the floor. Slowly draw your right knee up to your chest. Grab
the outside of the knee with your left hand and gently pull it toward your left shoulder as far as is comfortable. Hold for
20 seconds, then lower the leg back to the starting position. Repeat the move, this time raising your left knee and pulling it
toward your right shoulder. Alternating sides, do as many repetitions as you can.
Watch your form: Don’t curl up as you bring your knee forward. Focus on keeping your head, shoulders, and back pressed
flat against the floor.
SECTION 4: Any Position
Kneeling Leg Crossover
WORKS: gluteal muscles
Get on all fours with your hands and knees shoulder-width apart and your head parallel to the floor. Straighten your right leg
behind you, angling it to the right, with your toes touching the floor. This is the starting position. Now raise your right leg up
and over your left leg, then lower it until your right foot touches the floor just outside your left foot. Reverse the motion to
get back to the starting position and repeat as many times as you can. Switch positions to work your left leg. Alternate sides
as you do as many reps as possible.
Watch your form: Keep your spine straight throughout the move.
Sock Slide
WORKS: shoulders, chest, triceps, lower back, abs
For this move, you need to be in socks on a slippery surface. Assume the pushup position, with your hands flat on the floor
shoulder-width apart, your arms and legs straight, and your feet together. Keeping your hands in place, slowly slide your
body back until your nose is pointing down at the space between your hands. Next, slowly slide your body forward until
your belly is almost over your hands. Continue moving backward and forward as many times as you can.
Watch your form: Keep your arms straight, your abs in, and your back flat.
* For more sexual-performance-enhancing workouts, tips, and techniques, grab a copy of The Men’s Health Big Book of
Sex, available at www.menshealth.com/big-book-of-sex.
CHAPTER TEN
DOWNWARD DOGGY STYLE
Research shows that yoga helps PE. Here are 6 last-longer moves any man can master.
Limber women in tights bending over. Do you need another reason to join a yoga class? Well, how about this: Yoga can
increase your endurance between the sheets, according to a study in the Journal of Sexual Medicine.
The study, conducted at medical universities in India, involved 68 men suffering from premature ejaculation, Thirtyeight of the men were told to practice 12 yoga poses and a relaxation breathing technique called anulom vilom in which
you alternate closing one nostril at a time and breathing deeply (see “Breathing Lessons”). The rest of the men were given
fluoxetine (Prozac), the antidepressant, which is often used to treat PE. After 8 weeks, 25 of the 30 men on fluoxetine had
clinical improvement in staying power while all 38 men practicing yoga were able to triple the length of the time they lasted
during intercourse. And the men who did the asanas and yogic breathing reported no adverse side effects, unlike the drugtaking group.
“Yoga truly is sexercise,” says Vikas Dhikav, MD, a researcher and physician in New Delhi, India, who has studied
the relationship between yoga and PE. “It teaches men to control their anxiety and it improves strength and tone of the
abdominal-perineal muscles [abs and pelvic muscles].”
Men tend to have very tight hamstring, hip, shoulder, and lower-back muscles, all of which can hamper performance.
Yoga is the perfect fix for performance-hampering stiffness. Flexibility makes moving into positions more fluid and natural.
The following five moves are easy enough for beginners and they tackle the key areas, opening up your hips, flexing
the groin, loosening the lower back. Wear loose-fitting clothing and take your shoes and socks off. Grab a yoga mat if you
have one. Do these poses in order once a day. After completing the sequence once through, repeat it. Remember to keep your
breathing easy—inhaling and exhaling with each shifting movement. It should take you only about 15 minutes.
Chair Pose
This is an amazingly simple yet effective pose for strengthening the lower back and legs and building sexual stamina.
1. Stand with your feet together, your arms at your sides, and your sternum lifted. Bend your knees until your
thighs are at about 45 degrees to the floor and squeeze your thighs together.
2. Lift your straight arms above your head, keeping them in line with your torso. Stretch your fingertips toward
the sky. Accentuate the lift in your arms and chest so your upper spine is in a slight backbend. Tuck your
pelvis. Hold for 10 breaths.
TIP: Lift your toes up off the floor, squat deeper, and press your heels into the floor to get greater benefits from this pose.
Camel Pose
This classic, elegant yoga pose energizes the body while working your entire core.
1. Kneeling, with your body erect, check your alignment, making sure your knees are directly beneath your hips
and curling your toes under. Stack your hips on top of your knees, your shoulders atop your hips, and your
ears atop your shoulders.
2. Place the palms of your hands on the small of your back, fingertips facing up. If that is uncomfortable, your
fingertips can face the floor.
3. As you inhale, inflate your chest and feel your breastbone rise, floating your rib cage up and off your waist.
4. Then continue to lift your upper back up and over an imaginary ball behind you as you reach one hand and
then the other toward your heels. You should arrive at your deepest arch—in only your upper back—when
both hands rest comfortably on your heels.
5. Take 5 full, complete breaths, letting your head drop back; if that strains your neck, tuck your chin and relax
your face muscles instead. Keep your pelvis and thighs moving forward so your legs are lengthening.
6. To come back up, bring both hands to your lower back, and over 1 inhalation, use your core to lift your body
until it is erect. Move into child’s pose for 5 breaths to counteract this backbend (remain kneeling and fold
your body to lower your chest to your thighs while stretching your arms straight out on the floor in front of
you as far as you can).
TIP: If you cannot reach your heels, put tall blocks or firm pillows next to your ankles, or curl your toes under in order to
keep the weight forward so that the backbend stays in your upper back.
Downward Facing Dog
This basic pose is ideal for opening the shoulders, chest, and backs of the legs and for elongating the spine to release lower-
back tension.
1. Start on all fours with your wrists about 6 to 12 inches in front of your shoulders. Separate your knees hipwidth apart and curl your toes under.
2. Pushing evenly into your palms, lift your knees off the floor. Lift your sit bones toward the ceiling and push
the tops of your thighs back so your body looks like an inverted V.
3. At first, keep your knees bent and your heels lifted off the floor. Slowly straighten your knees—but don’t lock
them.
4. Gently begin to move your chest back toward your thighs until your ears are even with your upper arms;
don’t let your head dangle.
5. Keep your hips lifting and push strongly into your hands.
TIP: Not everyone needs to have their heels on the ground and straight knees (step 3). It’s better to stretch the heels away
from your head and then down, which elongates rather than yanks muscles.
Low Lunge
Strengthening your pelvic floor will enhance your staying power.
1. This one is similar to the lunge you do in the gym. Start with your feet hip-width apart and your arms at your
sides. Stand tall with your tailbone pointing down and your abs pulled in. When you do this, pretend that you
are holding urine in. That will tighten the muscles between the sit bones and pubic bone, making them taunt
like a trampoline.
2. Step forward one leg’s length with your right foot and lower yourself into a lunge. Bend forward at the waist
and press your fingertips to the floor on each side of your right foot.
3. You may need to step back a bit with your left leg so that it is fully extended and you are balanced on the
ball of your foot. Your right leg should be deeply bent. Hold for 10 breaths, then stand and lunge forward with
your left leg.
Standing Fan
The ultimate groin, hip, and hamstring stretch can unlock the pelvis and allow your mojo to move you.
1. Stand with your legs 4 feet apart and your toes pointed slightly inward and contract your leg muscles,
keeping your legs straight. But don’t lock your knees.
2. Bend forward from your hips, keeping your back straight. Place your hands on the back of a chair, on your
calves, or on the floor. (How low you go depends on the flexibility of your back and hamstrings!) Relax your
neck and allow it to dangle loosely without tension. Hold for 20 to 30 seconds, imagining the space between
each vertebra of your spine expanding. Your goal: to become so flexible that you can rest your forearms on
the floor.
BONUS CHAPTER
13 SECRETS TO ROCK-HARD ERECTIONS
The hidden link between erectile dysfunction and premature ejaculation—and how to ensure you’re never blindsided by
either
We’ve covered how to last longer in bed. We’ve covered every issue surrounding penis size. But no book on the subject
of your best buddy down below would be complete without offering some advice on how to achieve better erections—and
avoid (or eliminate) erectile dysfunction.
Here’s something few people know: ED and PE are linked, and having ED can in fact cause PE. Recent data show
that 30 to 50 percent of men with ED suffer from PE. Why? A man who has problems getting an erection requires more
manual stimulation to achieve that erection. And once he has it? He rushes the sex so he can finish before he loses his stiffy.
All of this raises his performance anxiety, which exacerbates the problem.
Like the other subjects in this book, no man likes to talk about ED. And that’s the problem. But hey, you’re here,
we’re here. Let’s talk. And let’s make sure you’ll always be fully functional when it’s time to have some fun with your
partner.
The first thing you should understand: No penis is an island. Or so J. Stephen Jones, MD, a urologist at the
Cleveland Clinic, likes to tell his patients. If your penis were an island, it would be tempting to think of it as a hot spot in the
Caribbean—calm and tranquil during the day, throbbing with activity at night, and the destination of a constant rotation of
half-naked coeds.
As much as that sounds like paradise, Dr. Jones says a more precise urological-geographical parallel is your penis
as a peninsula—a bodily extension that shares a supply of blood, oxygen, and nutrients with all your other organs (let’s
picture Florida, but a Florida that’s fully erect and pointing toward the North Atlantic). Unfortunately, that means if a natural
disaster strikes the mainland, it’s likely to affect any protruding landmasses, too.
“ED stands not only for ‘erectile dysfunction,’ but also for ‘early diagnosis,’ because you can use ED to predict a
heart attack, potentially by years—arterial damage from cardiovascular disease affects the small arteries in the penis first,”
says Christopher Steidle, MD, a urologist and investigator at Northeast Indiana Research in Fort Wayne. That’s one reason
it’s a mistake to let vardenafil (Levitra), sildenafil (Viagra), and tadalafil (Cialis) lull you into an I’ll-fix-it-when-it-breaks
mind-set.
But what if you don’t have any cardiovascular health issues? ED can also be caused by psychological issues. It could
simply be performance anxiety. You could also be overworked and under-rested. Stress and lousy sleep make you a prime
candidate for ED. Add alcohol to the mix and your chances rise even more.
Not to worry. Here are a dozen proven strategies to overcome all kinds of ED-causing problems. Take these steps to
safeguard your sex life now and you may never need to pop the little blue pill. Or any other shade of erection aid. In other
words, follow our advice and every woman who visits your peninsula will leave with a smile.
Strategy #1: Eat blackberry jam on your toast
Dark fruits like blackberries, bilberries, and elderberries contain high levels of anthocyanins, ultrapowerful antioxidants that
could act as erection insurance.
Why? Your penis’s ability to rise and shine depends, in part, on the availability of nitric oxide, a blood-vesseldilating chemical. When too many free radicals are present in your bloodstream, the nitric oxide level goes down and so
does your penis. Enter anthocyanins. These potent antioxidants attack free radicals before they have a chance to lower your
nitric oxide level.
Indiana University researchers found that arteries treated with anthocyanins retained high levels of nitric oxide even
after being flooded with free radicals. “Antioxidants help keep free radicals under control so nitric oxide can do its thing,”
says David Bell, PhD, the study’s lead author. And that “thing” is giving your penis the blood it needs to turn excitement
into an erection.
Strategy #2: Raise your fiber intake
As mentioned previously, the blood-vessel scarring that threatens your heart also threatens the tiny vessels that harden your
erection. So eat an apple and a bowl of oatmeal every day: Fiber is a great blood-vessel scouring agent.
Strategy #3: Work up a sweat once a day
One of the best and most convenient ways to increase bloodflow in the body is to exercise regularly. You’re supposed to be
doing it anyway, right? Well, we can’t think of a better incentive for that daily sweat session than a harder erection later that
night.
Strategy #4: Shut down the smokestack
If you still light up, you’ve probably accepted your increased risks of heart disease, stroke, lung cancer, and bladder cancer.
But how about dying young and impotent? A study published in the Journal of Urology found that smoking causes arterial
damage that doubles a man’s risk of erectile dysfunction. The good news: “If men quit in their 50s or earlier, we can usually
reverse the damage,” says André Guay, MD, director of the Lahey Clinic Center for Sexual Function in Massachusetts.
When Dr. Guay measured nighttime erections in 10 impotent smokers (average age: 49), he noted a 40 percent
improvement after just 1 smoke-free day. Swap the cancer sticks for fish sticks: Researchers at the Royal College of
Surgeons in Ireland discovered that taurine, an amino acid found in fish, helps heal smoke-damaged arteries.
Strategy #5: Become a more sensitive guy
Everyone knows stress is a psychological cold shower. But untamed tension also works in a more insidious way—by
releasing epinephrine, another name for adrenaline, that goes straight to your arteries and slowly wreaks havoc there. “Stress
in the long term can contribute to hardening of the arteries,” says Dr. Jones, who is the author of Overcoming Impotence: A
Leading Urologist Tells You Everything You Need to Know.
In a great medical irony, being hard in the arteries can leave you soft in the shorts. The fix: Force yourself to
concentrate on each of your five senses for a few minutes every day—the feel of the steering wheel in your hands, the sound
of the engine revving to redline, the sight of the hot brunette in the next car…
“Obsessing on stressful thoughts will increase your epinephrine,” says Jay Winner, MD, author of Stress
Management Made Simple. “On the other hand, if you focus on current sensations, it decreases the epinephrine and
ultimately improves your ability to have an erection.”
Strategy #6: Stop sawing wood
Snoring can sabotage a night of sex, and not just because it’s difficult to engage in foreplay from the couch. “All of your
tissue needs oxygen to be healthy, and the penile tissue is especially sensitive,” says Dr. Jones. “When you snore, you’re
depriving your tissue of that oxygen.”
That said, don’t waste your money on over-the-counter snore stoppers; research by the US Air Force shows that
these products aren’t effective. Instead, try placing bricks under the bedposts at the head of the bed. “Snoring has a lot to do
with gravity,” says Philip Westbrook, MD, founder of the sleep disorders center at the Mayo Clinic. “If you elevate the torso
without bending the neck, it changes the effect of gravity on the soft tissues of the throat.”
Strategy #7: Eat a dark-chocolate bar
It’s erection medicine. Dark chocolate contains epicatechins, flavonoids that trigger the release of dilating chemicals in the
inner, or endothelial, layer of the arteries. How much should you munch? A University of California at San Francisco study
showed that those who ate a 1.6-ounce dark-chocolate bar each day increased their blood-vessel dilation by more than 10
percent.
While the study wasn’t done specifically on erectile tissues, anything that benefits your body’s endothelial system
will likely benefit your erections, since the penis is made up largely of endothelial surfaces. “Keeping those surfaces healthy
is crucial to good arterial flow,” says Kevin McVary, MD, a professor of urology at Northwestern University. Look for dark
chocolate that bears the Cocoapro logo on the label—this symbol is a visible sign that the candy bar you’re buying is chockfull of flavonoids.
Strategy #8: Lower your estrogen
Calculate your body mass index. If your BMI comes in close to or over 25, you may be carrying just enough lard to drag
down your erections. “We know that heavier men convert testosterone to estrogen, and that a lower level of testosterone and
a higher level of estrogen are not good for erectile function,” says Larry Lipshultz, MD, a Men’s Health advisor and chief of
male reproductive medicine and surgery at Baylor College of Medicine.
Fortunately, even moderate weight loss can rid you of excess estrogen and put your sex life back on track. A study
published in the Journal of the American Medical Association found that one-third of clinically obese men—those with
BMIs of 30 or higher—with erectile dysfunction showed improvement after losing 10 percent of their body weight.
Strategy #9: Get pricked
If you think the problem is that you, well, think too much, see an acupuncturist. The results of a study published in
the International Journal of Impotence Research suggest that acupuncture can help treat psychologically induced erectile
dysfunction. (Relax—the prick points are all in your back.)
“In psychogenic erectile dysfunction, the patient has trouble with the balance of his sympathetic and parasympathetic
nervous systems,” says Paul Engelhardt, MD, the study’s author. “Traditional Chinese medicine tries to restore that balance.”
Sure, it sounds like using feng shui for your underwear drawer, but it works—64 percent of the men who underwent 6 weeks
of acupuncture regained sexual function and needed no further treatment.
Strategy #10: Build a stronger floor
Go figure—one of the best ways to treat erectile dysfunction is to pretend that you suffer from premature ejaculation. British
researchers discovered that the common treatment for a hair trigger—strengthening the pelvic floor muscles, which we
covered in Chapter 4—is also a remedy for men who can’t point their pistols. In the study of 55 impotent men, 40 percent of
those who practiced pelvic floor exercises, aka Kegels, every day for 6 months regained normal sexual function.
Apparently, the same muscle contraction that’s used to stop peeing midstream can also prevent blood from escaping
during an erection. “Unless they have severe back pain, all men with ED can perform pelvic floor exercises,” says Grace
Dorey, PhD, the study’s author. Here’s the workout plan: Contract and relax your pelvic muscles anytime you’re sitting,
although you can also do them lying down. Work up to doing 18 contractions daily, holding each one for 5 to 10 seconds.
Strategy #11: Ask your doctor about niacin
Do chicken breasts give you erections? If yes, then you have serious issues; please see a psychologist. But the idea isn’t too
far-fetched: The vitamin niacin (B3)—found in chicken, fish, and grains, to name a few—may help you overcome ED if you
have high cholesterol, according to a new study published in the Journal of Sexual Medicine.
Niacin helps the body process fats, and studies have shown that it reduces cholesterol. Like statins, which have also
been shown to improve ED, niacin increases bloodflow throughout the body by opening arteries. More bloodflow makes for
a stronger, more reliable erection.
The team, led by Chi-Fai Ng, MD, gave men with high cholesterol and ED niacin or a placebo over 12 weeks. Men
who got niacin said they were better able to maintain erections during sex after 12 weeks, compared to those who got only
placebos. Men with severe ED saw even greater improvements.
Since niacin has few side effects—mainly facial flushing and itchy skin—Dr. Ng says that it could eventually be a
good alternative treatment for ED in men with high cholesterol. They didn’t test men without high cholesterol or compare
niacin to other ED drugs, like Viagra, so he says further research is needed to see if it works for other guys, too.
But consider this before you binge on chicken breasts: You’ll need to eat nearly 200 of them a day to get the 1,500
milligram dose of niacin that study volunteers received. Don’t just head to the local health food store for niacin supplements,
either, warns Dr. Lipschultz. Not only do supplements often contain less than the bottle says, but ED can also be a precursor
to heart disease—a condition you should treat with your doctor’s advice. Men with ED should be screened for heart and
vascular problems by a doctor before starting niacin treatment, he recommends.
Strategy #12: Open your medicine cabinet
And make a list of all the prescription pills you’re popping. “A lot of prescription drugs may be associated with sexual
dysfunction,” says R. Taylor Segraves, MD, PhD, coauthor of Sexual Pharmacology: Fast Facts. One possible culprit is
the cholesterol-lowering drug simvastatin (Zocor). For a full list of erection offenders, visit www.MensHealth.com/drug. If
you’re taking one of them, talk to your doctor. Often a similar pill, one sans side effects, is on the market.
Strategy #13: Still not able to defy gravity?
At this point, it makes sense to consider taking Viagra, Cialis, or Levitra to stimulate bloodflow to the penis, says Dr. Steidle.
And who knows what miracles might happen once you prime the pump a few times? “What a lot of men find is that once
they [are taking] these medications, they may not need them for every episode of sexual activity—they may need them only
now and then,” he says.
Similarly, if you suffer from performance anxiety, a drug-fueled romp or two may be just what the urologist ordered
to restore confidence. And while all three erection medications have the power to prevent you from psyching yourself out
in the sack, Cialis’s ability to work for up to 36 hours may provide an advantage, says Julian Slowinski, PsyD, an assistant
professor of psychology in psychiatry at the University of Pennsylvania school of medicine. “This gives a man and his
partner a lot of time over the weekend to be more spontaneous.”
Warmups for Your Pushups
The perfect pre-sex stretch
Despite its less than adequate name, the inchworm is a great sexercise. Use it as a warmup before you get busy or
as a full-body workout when you don’t have time for your regular routine. It loosens thighs, hips, obliques, back, and
shoulders.
HOW TO DO THE INCHWORM:
• Stand with your legs straight and feet hip-width apart. Bend at the waist and place your hands on the floor.
• Keeping your legs straight, walk your hands forward while keeping your abs and lower back braced. Then
take tiny steps to walk your feet up to your hands. That’s 1 repetition. Do 6.
Erection Protection+
A study by Harvard researchers of 31,000 men over the age of 50 proves that daily strolls can keep
the lead in your pencil. Men who did aerobic activity equivalent to walking briskly for 2 miles daily
cut their risk of impotence by 30 percent.
Breathing Lessons
Yogic breathing eases performance anxiety
If you are always in fight-or-flight mode, you cannot be in tune with your body or hers and delaying your ejaculation
is more difficult to do. That’s why yoga practice can help. The poses and breathing techniques create calm and teach
body control. A specific yogic relaxation breathing technique called anulom vilom, or alternate-nostril breathing, has
been shown to reduce anxiety and improve sexual performance in men and satisfaction in women. A study in the
journal Applied Psychophysiology and Biofeedback offers a possible reason why: lower blood pressure. Researchers
say nerves in each nostril reach parts of the hypothalamus that regulate blood pressure. Stimulating the nerves
separately by breathing through one nostril at a time activates the hypothalamus and triggers the parasympathetic
nervous system’s calming effect. It also forces you to breathe deeply, filling your lungs and bringing more oxygen
into the bloodstream. a
“Performance anxiety is an important precipitating factor for PE,” says Vikas Dhikav, MD, who researched this
at All India Institute of Medical Sciences in New Delhi. “Deep yoga breathing teaches men to control anxiety in body
and mind. If someone is relaxed, he can hold on for more time.”
Try it yourself: Sit in a comfortable position. Place your right hand over your nose so that your thumb rests
near your right nostril and your ring finger is positioned next to your left. Close your right nostril with your thumb
and inhale through your left nostril for a count of 4. Close your left nostril with your ring finger and hold your breath
for a count of 4. Now release your thumb and exhale through your right nostril for a count of 4. Breathe in through
the right, pause, close that nostril and release the left and breathe out through the left nostril. That’s 1 round.
Continue this pattern for about 5 minutes. Do it a couple of times a week.